Tests help nail down HCV -but not entirely

Article Abstract:

Discovery of the virus that causes hepatitis C (HCV) led researchers to hope that cases of hepatitis formerly identified as 'non-A, non-B' could be rediagnosed as hepatitis C. However, many people with hepatitis who do not test positive for hepatitis A or B, also fail to test positive for HCV. Different tests may classify the same patient as positive or negative; in high-risk populations, the sensitivity (true positives) of one test is only 85 percent. Newer forms of recombinant immunoblot assays (RIBA) may provide better accuracy in testing blood donors, many of whom test positive and then test negative on subsequent assays. Another goal for the tests under development is to shorten the interval between infection with HCV and the time the test will give a positive result. This window, which can currently be as long as one year, will be cut to about 20 weeks with new RIBA tests, and to two weeks with tests based on the polymerase chain reaction. Under current conditions, screening blood donors could require following people for many months. The rate of infection with non-A, non-B hepatitis in the US is 170,000 each year. HCV infection rates are similar throughout the world (1.5 percent). The earliest HCV tests give positive results in 68 percent of these cases when they are followed for six months. An especially low rate of positive results (50 percent) is found when testing people with acute non-A, non-B hepatitis. Transfusions and intravenous drug use are the main ways HCV is transmitted; it is not clear if transmission through sexual contact or household routes occurs. While patients who are HCV-positive have a much higher rate of multiple partners, the infection rate among gay men, while higher than that for controls, is not dramatically elevated. Household contact may be implicated, but clear-cut evidence is lacking. A problem in learning more about HCV transmission is its long latency. Some researchers also believe that other forms of hepatitis besides A, B, and C are responsible for the current diagnostic difficulties. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Hepatitis C, Disease transmission, Hepatitis C virus, Diagnosis, Laboratory, Laboratory diagnosis

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Proposed card, intended to facilitate medical billing, record keeping, draws mixed reviews

Article Abstract:

The Department of Health and Human Services recently made several proposals to reduce health care cost and increase efficiency of health care delivery. Every insured person would be provided with a credit card linked to an electronic billing system. The card would contain the patient's medical history and insurance coverage. Opponents of this plan claim that it would only reduce administrative paperwork by 10%. A universal claim form would be used by all insurance companies. Medical records would be stored in a central database to provide easy access to patient information. Many consumers and doctors fear that centralization of medical records may threaten patient confidentiality.

Medical care, Contracts, Political aspects, Information services, Health insurance, Medical records

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