The proportions of nonincarcerated persons born during 1945–1965 with newly diagnosed cases of confirmed HCV infection (2) who were linked to care during the preenactment period (January 2011–December 2013) and the postenactment period (January 2014–December 2014) were compared.Linkage to care was defined as documentation of either 1) two or more positive HCV RNA tests (excluding reflex RNA testing) or 2) one positive HCV RNA test (excluding reflex RNA testing) and an HCV genotype test within 6 months of the initial positive HCV antibody result.
Approximately 75% of all hepatitis C virus (HCV) infections in the United States and 73% of HCV-associated mortality occur in persons born during 1945–1965, placing this birth cohort at increased risk for liver cancer and other HCV-related liver disease (1).
In the United States, an estimated 2.7 million persons are living with HCV infection, and it is estimated that up to 75% of these persons do not know their status.
Persons born during 1945–1965 account for approximately 75% of all hepatitis C virus (HCV) infections in the United States and 73% of HCV-associated mortality. In January 2014, New York became the first state to enact an HCV testing law, which is expected to increase the number of persons who are aware of their HCV status. One year after implementation of the 2014 New York HCV Testing Law, marked increases were observed in the number of HCV screening tests and rates of testing.
Increases were observed almost immediately after enactment of the law and remained steady at levels substantially higher than those in the years preceding enactment of the law.
In reflex RNA testing, a positive antibody test result triggers an automatic RNA test by the laboratory on the same specimen.
For this analysis, reflex testing was defined as an HCV RNA test with the same collection date as the HCV antibody test.
Twelve (7.4%) laboratories did not meet eligibility requirements and were excluded from the evaluation.
In addition to the laboratory survey, New York Medicaid data were used to assess trends in HCV testing before and after implementation of the law.
Deidentified Medicaid claims and encounter data were used to create monthly denominators for the entire Medicaid population over a 3-year period (January 2012 through December 2014).
Only Medicaid recipients born between 19 (aged 50–70 years in 2015) receiving paid services during a given month during the study period (active Medicaid clients) were included in this analysis.
State-level HCV testing laws could increase the number of persons who know their HCV status and of HCV-infected persons who are linked to care.