{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T01:23:06Z","timestamp":1792891386589,"version":"4.5.0"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection is highly effective but remains underused. Understanding disparities in the delivery of DAAs is important for HCV elimination planning and designing interventions to promote equitable treatment.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine variations in the receipt of DAA in the 6 months following a new HCV diagnosis.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective cohort study used national Medicaid claims from 2017 to 2019 from 50 states, Washington DC, and Puerto Rico. Individuals aged 18 to 64 years with a new diagnosis of HCV in 2018 were included. A new diagnosis was defined as a claim for an HCV RNA test followed by an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision<\/jats:italic> (ICD-10<\/jats:italic>) diagnosis code, after a 1-year lookback period.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Outcome was receipt of a DAA prescription within 6 months of diagnosis. Logistic regression was used to examine demographic factors and ICD-10<\/jats:italic>\u2013identified comorbidities associated with treatment initiation.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 87\u202f652 individuals, 43\u202f078 (49%) were females, 12\u202f355 (14%) were age 18 to 29 years, 35\u202f181 (40%) age 30 to 49, 51\u202f282 (46%) were non-Hispanic White, and 48\u202f840 (49%) had an injection drug use diagnosis. Of these individuals, 17\u202f927 (20%) received DAAs within 6 months of their first HCV diagnosis. In the regression analyses, male sex was associated with increased treatment initiation (OR, 1.24; 95% CI, 1.16-1.33). Being age 18 to 29 years (OR, 0.65; 95% CI, 0.50-0.85) and injection drug use (OR, 0.84; 95% CI, 0.75-0.94) were associated with decreased treatment initiation. After adjustment for state fixed effects, Asian race (OR, 0.50; 95% CI, 0.40-0.64), American Indian or Alaska Native race (OR, 0.68; 95% CI, 0.55-0.84), and Hispanic ethnicity (OR, 0.81; 95% CI, 0.71-0.93) were associated with decreased treatment initiation. Adjustment for state Medicaid policy did not attenuate the racial or ethnic disparities.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In this retrospective cohort study, HCV treatment initiation was low among Medicaid beneficiaries and varied by demographic characteristics and comorbidities. Interventions are needed to increase HCV treatment uptake among Medicaid beneficiaries and to address disparities in treatment among key populations, including younger individuals, females, individuals from minoritized racial and ethnic groups, and people who inject drugs.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.27326","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T15:31:22Z","timestamp":1691163082000},"page":"e2327326","source":"Crossref","is-referenced-by-count":34,"title":["Hepatitis C Treatment Initiation Among US Medicaid Enrollees"],"prefix":"10.1001","volume":"6","author":[{"given":"Shashi N.","family":"Kapadia","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Weill Cornell Medicine, New York, New York"},{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisakha","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Organization, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Franco","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at 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Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Dharia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Statistics and Data Science, Cornell University, Ithaca, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhua","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin F","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Weill Cornell Medicine, New York, New 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