New Medi-Cal policy issued for treating hepatitis C

On July 3, 2018, California Department of Public Health issued the following communication.

Dear Community Partners:

I am very excited to announce that today the California Department of Health Care Services (DHCS) released a new hepatitis C treatment policy for Medi-Cal beneficiaries. The new Medi-Cal policy lifts previous HCV treatment restrictions (e.g., requiring fibrosis score of 2 or higher). It only excludes people with a life expectancy of <12 months (and people too young for FDA-approved medications). See policy here.

In other news…

1. Hepatitis C Treatment Policy for State Prisons Expanded
The California Department of Correctional Health Care Services also have updated HCV treatment guidelines for state prisons, which are consistent with the Medi-Cal guidelines in recommending treatment except for people with limited life expectancy (and in consideration of other logistical factors specific to prisons). The new care guide is available here.

2. Updated AASLD/IDSA Guidelines for Hepatitis C Screening and Treatment for At-Risk Populations
The Association for the Advanced Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) now recommend testing for hepatitis C:
· During pregnancy at first visit
· For people who have ever been incarcerated
· At HIV pre-exposure prophylaxis (PrEP) initiation
· For HIV positive men who have sex with men (annually)
· For people who inject drugs (annually)

3. CDC Health Advisory – Outbreak of Hepatitis A Virus (HAV) Infections among Persons Who Use Drugs and Persons Experiencing Homelessness

4. New State Viral Hepatitis Data Analyses Available
CDPH Office of Viral Hepatitis Prevention staff presented a number abstracts at the Council of State and Territorial Epidemiologists (CSTE) conference, including preliminary findings from the hepatitis C testing and linkage to care demonstration projects. Abstracts are posted here.

5. HCV Testing and Linkage to Care Demonstration Projects Completed
Last but not least, the HCV testing and linkage to care demonstration projects ended 6/30. Thanks to all of the HCV demo project sites for their incredible work!!! Through their effort, more than 700 people were treated for hepatitis C, and the majority were people who inject drugs! Evaluation findings will be summarized and shared with local and community partners this fall.

Rachel McLean, MPH
Chief, Office of Viral Hepatitis Prevention
California Department of Public Health