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Peer-reviewedCC BYMedical care

Hepatitis C Virus Cascade of Care in Florida Emergency Departments

  • Pilar Hernandez-Con1
  • Suk-Chan Jang1
  • Steven M. Smith1,2
  • Chanakan Jenjai1
  • Faheem Guirgis3
  • Michael C. Petrauskis3
  • Christine Gage4
  • Haesuk Park1,2
4 affiliations
  1. 1Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
  2. 2Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida, USA.
  3. 3Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, USA.
  4. 4Department of Emergency Medicine, College of Medicine, University of Florida, Jacksonville, Florida, USA.
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Abstract

BACKGROUND: Florida has the second-highest rate of acute hepatitis C virus (HCV) infection cases in the United States. However, HCV care cascade outcomes among individuals seeking care in Florida emergency departments (EDs) remain unknown. OBJECTIVES: To assess HCV care cascade outcomes and identify HCV infection predictors among individuals tested for HCV in Florida EDs. RESEARCH STUDY DESIGN: This retrospective study used electronic health records (2016-2023) linked to the Agency for Healthcare Research and Quality on Social Determinants of Health regional data. SUBJECTS: Adults aged 18-79 years tested for HCV infection in Florida EDs. MEASURES: Outcomes included the proportions of individuals completing each HCV care cascade step: (1) HCV screening; (2) HCV diagnosis; (3) linkage to care; and (4) treatment initiation. A multivariable logistic regression model was used to identify predictors of HCV infection. RESULTS: Among individuals seeking care in EDs, 4.98% (n=18,444) were tested for HCV, of whom 4.97% were confirmed HCV-positive. Among HCV-positive individuals, 11.24% were linked to care, and 2.84% initiated treatment. Significant predictors of HCV infection included having Medicaid insurance (OR=1.53, 95% CI: 1.14-2.07) or being uninsured (OR=2.88, 95% CI: 2.02-4.12), coinfection with human immunodeficiency virus (OR=28.99, 95% CI: 22.31-37.67), opioid injection drug use (OR=3.62, 95% CI: 2.76-4.75), opioid overdose (OR=3.89, 95% CI: 2.32-6.52), and residing in communities characterized by lower educational attainment (fourth quartile OR=1.95, 95% CI: 1.27-2.98). CONCLUSIONS: Significant gaps persist across the HCV care cascade among individuals tested in Florida EDs. Innovative public health interventions are needed to support these vulnerable populations.

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Cite

BibTeXRIS
BibTeX
@article{hernandezcon2026hepatitis,
  title = {{Hepatitis C Virus Cascade of Care in Florida Emergency Departments}},
  author = {Pilar Hernandez-Con and Suk-Chan Jang and Steven M. Smith and Chanakan Jenjai and Faheem Guirgis and Michael C. Petrauskis and Christine Gage and Haesuk Park},
  journal = {Medical care},
  year = {2026},
  month = jul,
  doi = {10.1097/mlr.0000000000002354},
  url = {https://doi.org/10.1097/mlr.0000000000002354},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Hepatitis C Virus Cascade of Care in Florida Emergency Departments
AU  - Pilar Hernandez-Con
AU  - Suk-Chan Jang
AU  - Steven M. Smith
AU  - Chanakan Jenjai
AU  - Faheem Guirgis
AU  - Michael C. Petrauskis
AU  - Christine Gage
AU  - Haesuk Park
PY  - 2026
DA  - 2026/07/01
JO  - Medical care
DO  - 10.1097/mlr.0000000000002354
UR  - https://doi.org/10.1097/mlr.0000000000002354
AB  - BACKGROUND: Florida has the second-highest rate of acute hepatitis C virus (HCV) infection cases in the United States. However, HCV care cascade outcomes among individuals seeking care in Florida emergency departments (EDs) remain unknown. OBJECTIVES: To assess HCV care cascade outcomes and identify HCV infection predictors among individuals tested for HCV in Florida EDs. RESEARCH STUDY DESIGN: This retrospective study used electronic health records (2016-2023) linked to the Agency for Healthcare Research and Quality on Social Determinants of Health regional data. SUBJECTS: Adults aged 18-79 years tested for HCV infection in Florida EDs. MEASURES: Outcomes included the proportions of individuals completing each HCV care cascade step: (1) HCV screening; (2) HCV diagnosis; (3) linkage to care; and (4) treatment initiation. A multivariable logistic regression model was used to identify predictors of HCV infection. RESULTS: Among individuals seeking care in EDs, 4.98% (n=18,444) were tested for HCV, of whom 4.97% were confirmed HCV-positive. Among HCV-positive individuals, 11.24% were linked to care, and 2.84% initiated treatment. Significant predictors of HCV infection included having Medicaid insurance (OR=1.53, 95% CI: 1.14-2.07) or being uninsured (OR=2.88, 95% CI: 2.02-4.12), coinfection with human immunodeficiency virus (OR=28.99, 95% CI: 22.31-37.67), opioid injection drug use (OR=3.62, 95% CI: 2.76-4.75), opioid overdose (OR=3.89, 95% CI: 2.32-6.52), and residing in communities characterized by lower educational attainment (fourth quartile OR=1.95, 95% CI: 1.27-2.98). CONCLUSIONS: Significant gaps persist across the HCV care cascade among individuals tested in Florida EDs. Innovative public health interventions are needed to support these vulnerable populations.
SN  - 0025-7079
SN  - 1537-1948
ER  -