The Mystery of Hepatitis C Prevalence…Solved

Medivo Proves Hepatitis C Prevalence is Underreported

By Carol Smyth, MD & Brian Saindon

 

If you are just tuning in, this is the fourth blog post in a five part series exploring Hepatitis C prevalence.  Our experts are concluding an analysis of HCV+ patients within Medivo’s lab test database.  Last week, we examined available data from health agencies reporting counts of patients diagnosed with HCV in New York State.  If you missed it, read about those counts as well as our study methods here.

Since last week, our team has been working hard to identify the number of patients in Medivo’s database diagnosed with HCV+ within the same regions and during the same time period.  Our goal is to identify gaps, and therefore enable healthcare professionals to better understand Hepatitis C prevalence and incidence in New York, which will inform education and treatment programs to improve patient health.

Chart 1 shows that the Medivo database captures an additional 11,948 individuals as being newly diagnosed with HCV in NYC and an additional 3,623 individuals as being newly diagnosed with HCV in NYS (excluding NYC) during the 2014 time period as compared to the numbers reported by the NYC DHMH and NYS DOH.  Acknowledging that Medivo has identified a larger number individuals diagnosed with HCV suggests that the incidence of HCV in both New York State and New York City is underreported.

Chart 1a. Overall Count of HCV + Past or Present Cases Identified in 2014 in New York City Using NYC DHMH and Medivo Data

hepatitis c prevalence Medivo/NYS

Chart 1b. Overall Count of HCV + Past or Present Cases Identified in 2014 in New York State Excluding NYC Using NYS DOH and Medivo Data

screen-shot-2016-10-21-at-1-52-43-pm

Similar to last week’s data, Chart 2a and 2b identify age-stratified counts for each region during 2014.  This week, we include Medivo’s age-stratified counts in order to compare differences in age distributions between Medivo’s patient population and the patient populations provided by the NYS DOH and NYC DHMH.  For New York City, the age distribution between data sources is relatively similar between NYC DHMH and Medivo data sources.  For New York State (excluding NYC), we see slight differences in the 20-29, 50-59 and 60+ age groups between Medivo’s data source and NYS DOH’s data source, but it’s a bit difficult to visually compare distribution without converting the raw counts into percentages.  

 

Chart 2a. Age Stratified Count of HCV + Past or Present Cases Identified in 2014 in Both Locations and From Both Sources

screen-shot-2016-10-21-at-1-53-07-pm

 

Let’s take a look at Chart 2a, which converts these distributions into percentages.  Below (in Chart 2b), you can more clearly see the differences in age group distributions for New York State (excluding NYC) between data sources.  In particular, you will see that the 20-29 age group in Medivo’s data represents 12.3% of the NYS (excluding NYC) region as compared to 19.4% reported by the NYS DOH.  Notice another difference within the 60+ age group: in Medivo data, the 60+ age group represents 29.6% of those identified as having HCV in the NYS (excluding NYC) region whereas the NYS DOH reports that the 60+ age group represents 25.4% of all individuals diagnosed with HCV in this region.  As mentioned in Blog 3, acknowledging differences in age group distribution between different locations can help lead to more efficient HCV intervention targeting.  

 

Chart 2b. Age Stratified Percentages of HCV + Past or Present Cases Identified in 2014 in Both Locations and From Both Sources

screen-shot-2016-10-21-at-1-53-20-pm

 

As we mentioned at the beginning of this post, the latest report on HCV counts released by the New York State Department of Health and New York City Department of Health and Mental Hygiene account for the year of 2014.  Since Medivo has access to current HCV laboratory data and we looked at this data upt to May of 2016, we present Chart 3, which identifies the number of individuals diagnosed with HCV during the 2015 through May 2016 time period.  During this time period, we have identified an additional 23,941 and 13,721 new cases of patients diagnosed with HCV in NYC and NYS (excluding NYC), respectively.  At the time of this post, we have not identified any published reports from the NYC DHMH or the NYS DOH to identify similar metrics on newly identified HCV cases across the 2015 or 2016 time periods. Having quick access to identify these 37,662 newly diagnosed HCV + individuals can help rapidly identify patients in need of HCV treatment.

 

Chart 3. Overall Count of HCV + Past or Present Cases Identified in 2015 – 2016  in New York Using Medivo Data

screen-shot-2016-10-21-at-1-53-29-pm

 

Summary

This HCV study suggests that New York State has more HCV cases than are currently being identified by the NYS DOH and NYC DHMH.  Specifically, our study identified 15,571 more patients diagnosed with HCV across all of NYS in 2014 as compared to the NYSDOH and NYC DHMH sources.  Knowing that there are more HCV cases, and the number of unidentified cases in public health records, helps to better estimate the amount of HCV treatment needed across NYS.

In addition to 2014, this study has identified the latest counts of newly identified patients with HCV across NYS for 2015 and part of 2016.  We have identified 37,662 newly identified patients with HCV that cannot be matched up yet to reports from public health services, as we await publication of these numbers.  

The results of this study suggest you must incorporate multiple data sources in order to identify the true burden of HCV in New York State. Relying only on one data source, for example public health available data sources, can result in an underestimate of the true prevalence of HCV.  In NYC Medivo identified 2.6 times the number of HCV patients for 2014 as reported by the NYC DHMH.  In NYS (Excluding NYC)  Medivo identified 1.5 times the number of HCV patients for 2014 as reported by the NYS DOH.  Quick identification of newly identified HCV patients can help HCV-diagnosed patients more quickly receive needed treatment. Treating HCV + patients early can reduce morbidity and mortality in later years which can translate to reduced future health cost.

 

This is the fourth blog post in a five part series.  Stay tuned for our next blog post in which we will further discuss the implications of our study findings.  We welcome your comments and feedback regarding any part of this blog series. Please comment below, or reach out to us at info@medivo.com.

Sources:
  1. https://www.health.ny.gov/statistics/diseases/communicable/2014/
  2. http://www1.nyc.gov/assets/doh/downloads/pdf/cd/hepatitis-b-and-c-annual-report.pdf

Previous Post | Next Post

©2016 Medivo Inc., All Rights Reserved.

Up Next

Terms of Use | Privacy | © 2017 Prognos. All rights reserved