Impact of race/ethnicity and gender on HCV screening and prevalence among U.S. veterans in Department of Veterans Affairs Care

Abstract

Objectives: We assessed HCV screening and prevalence among veterans and estimated the potential impact of complete birth cohort screening, accounting for the disparate HCV disease burden by race/ethnicity and gender.

Methods: We used the Department of Veterans Affairs (VA) Corporate Data Warehouse to identify birth dates, gender, race/ethnicity, and laboratory tests for veterans with at least 1 VA outpatient visit in 2012. We calculated HCV screening rates, prevalence, and HCV infection incident diagnosis.

Results: Among 5,499,743 veterans, 54.7% had HCV screening through the VA. In more than 2.9 million veterans screened, HCV prevalence was 6.1% overall and highest among Blacks (11.8%), particularly Black men born in 1945 to 1965 (17.7%). HCV infection incident diagnosis in 2012 was 5.9% for men and 2.3% for women. An estimated additional 48,928 male veterans, including 12,291 Black men, and 1484 female veterans would potentially be identified as HCV infected with full birth cohort screening.

Conclusions: HCV prevalence was markedly elevated among veterans born in 1945 to 1965, with substantial variation by race/ethnicity and gender. Full adoption of birth cohort screening may reveal substantial numbers of veterans with previously unknown HCV infection.

FIGURE 1—

HCV screening by race/ethnicity among veterans who were (a) male and (b) female: Department of Veterans Affairs Corporate Data Warehouse, United States, 2012.

FIGURE 2—

HCV infection prevalence by race/ethnicity among veterans who were (a) male and (b) female: Department of Veterans Affairs Corporate Data Warehouse, United States, 2012.

FIGURE 3—

HCV incident diagnosis by year of first HCV screening among veterans born 1945–1965 by (a) gender and (b) race/ethnicity: Department of Veterans Affairs Corporate Data Warehouse, United States, 2012.