Hepatitis C Screening

On this page...
		Performance Measure
		Numerator
		Denominator
		Patient Exclusions
		Data Element
		Data Sources
		National Goals, Targets or Benchmarks for Comparison
		Outcome Measures for Consideration
		Basis for Selection and Placement in Group 2
		US Public Health Service Guidelines
		References/Notes

Percentage of clients for whom Hepatitis C (HCV) screening was performed at least once since the diagnosis of HIV infection.

Number of HIV-infected clients who have documented HCV status in chart [ 1 ]

Number of HIV-infected clients who had a medical visit with a provider with prescribing privileges [ 2 ] at least once in the measurement year

None

1. Is the client HIV-infected? (Y/N)
1. If yes, is there documentation of the client's Hepatitis C status in the medical record? (Y/N)

• Ryan White Program Data Report, Section 5, Items 42 and 48 may provide data useful in establishing a baseline for this performance measure
• Electronic Medical Record/Electronic Health Record
• CAREWare, Lab Tracker, or other electronic data base
• HIVQUAL reports on this measure for grantee under review
• Medical record data abstraction by grantee of a sample of records

IHI Goal: 95% [ 3 ]

National HIVQUAL Data [ 4 ]

	2003	2004	2005	2006
Top 10%	100.0%	100.0%	100.0%	100.0%
Top 25%	99.4%	100.0%	100.0%	100.0%
Mean*	86.2%	88.8%	90.5%	90.9%

*from HAB data base

• Hepatitis C- related mortality rates in the clinic population

Chronic hepatitis C infection is common in persons with HIV infection, and although it is a source of substantial morbidity and mortality, it may be amenable to treatment. HIV/ hepatitis C co-infection may predispose HIV-infected patients to liver toxicity from HAART [ 5 ] and HCV treatment may exacerbate the side effects of some ARV medications. [ 6 ]

Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment decisions that affect a sizable population. Measure has a strong evidence base supporting the use.

"All HIV-infected patients should be screened for HCV infection" [ 7 ] (6/14/02) .

[1] Unless there is concern about ongoing exposure (e.g., via active injection drug use), annual re-screening is not generally recommended.

[2] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe ARV therapy.

[3] IHI Measure reads, " Percent of Patients/Clients with Known Hepatitis C Status"
(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsClientswith
KnownHepatitisCStatus.htm)

[4] (http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf)

[5] AIDS Institute, New York State Department of Health. Criteria for the Medical Care of Adults with HIV Infection, Hepatitis C Virus Updated September 2004 [Text taken from the NYSDOH AI publication - "Criteria for the Medical Care of Adults with HIV Infection"] (http://www.hivguidelines.org/public_html/hep-c/hepc.pdf)

[6] Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
(http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf)

[7] Centers for Disease Control and Prevention. Guidelines for Preventing Opportunistic Infections Among HIV-Infected Persons - 2002 Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America . MMWR 2002;51(No. RR-8) (http://www.cdc.gov/mmwr/PDF/rr/rr5108.pdf or http://aidsinfo.nih.gov/ContentFiles/OIpreventionGL.pdf).