Patients Receiving Methadone More Likely to Undergo Hepatitis C Screening Among Medicaid-insured New Yorkers With Opioid Use Disorder

Rates of hepatitis C virus (HCV) infection have more than doubled over the last decade in the US. Injection drug use is the primary risk factor for HCV; thus, it is important to screen people with opioid use disorder (OUD) for it. The US Centers for Disease Control and Prevention recommend one-time HCV screening in all adults and periodic testing while risk factors persist. However, few studies have reported the prevalence of HCV screening in people with OUD. This cross-sectional study examined the association between receipt of different types of OUD treatment and HCV screening in 2014 among patients with New York State Medicaid diagnosed with OUD.

• Of the 79,764 patients identified with OUD, 48% received medications for opioid use disorder (MOUD) and 32% received non-pharmacologic OUD treatment.
• Compared with patients receiving no OUD treatment, patients receiving methadone were most likely to be screened for HCV (32%), followed by patients receiving naltrexone (21%), patients receiving buprenorphine (16%), and patients receiving non-pharmacologic treatment (17%).

Comments: A minority of this cohort of patients with OUD were screened for HCV in 2014, despite federal recommendations. However, these data suggest that engagement in OUD treatment, particularly MOUD, is associated with increased rates of HCV screening. Moreover, the higher rates of screening in patients receiving methadone, which is only dispensed via regulated opioid treatment programs, suggest that federal and state policy can have a significant impact on HCV screening.

Leah H. Harvey, MD, MPH* & Alexander Y. Walley, MD, MSc

* Contributing editorial intern and Infectious Disease and Addiction Medicine Fellow, Boston Medical Center

Reference: Choi S, Healy S, Shapoval L, et al. Hepatitis C virus screening among Medicaid-insured individuals with opioid use disorder across substance use disorder treatment settings. Subst Use Misuse. 2021;56(2):258–263.