Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

Alain H. Litwin, Bryce D. Smith, Mari Lynn Drainoni, Melissa D. McKee, Allen L. Gifford, Elisa Koppelman, Cindy L. Christiansen, Cindy M. Weinbaum, William N. Southern

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Background: An estimated 3.2 million persons are chronically infected with the hepatitis C virus (HCV) in the U.S. Effective treatment is available, but approximately 50% of patients are not aware that they are infected. Optimal testing strategies have not been described. Methods: The Hepatitis C Assessment and Testing Project (HepCAT) was a serial cross-sectional evaluation of two community-based interventions designed to increase HCV testing in urban primary care clinics in comparison with a baseline period. The first intervention (risk-based screener) prompted physicians to order HCV tests based on the presence of HCV-related risks. The second intervention (birth cohort) prompted physicians to order HCV tests on all patients born within a high-prevalence birth cohort (1945-1964). The study was conducted at three primary care clinics in the Bronx, New York. Results: Both interventions were associated with an increased proportion of patients tested for HCV from 6.0% at baseline to 13.1% during the risk-based screener period (P< 0.001) and 9.9% during the birth cohort period (P< 0.001). Conclusions: Two simple clinical reminder interventions were associated with significantly increased HCV testing rates. Our findings suggest that HCV screening programs, using either a risk-based or birth cohort strategy, should be adopted in primary care settings so that HCV-infected patients may benefit from antiviral treatment.

Original languageEnglish (US)
Pages (from-to)497-503
Number of pages7
JournalDigestive and Liver Disease
Issue number6
StatePublished - Jun 2012


  • Chronic hepatitis C
  • HCV
  • Primary care
  • Public health
  • Screening

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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