P5762 - The Impact of Language Discordance Between Primary Care Providers and Patients on Hepatitis C Follow-Up After Positive Screening: A Multi-Center Analysis

Jason C. Truong, DO, MS¹, Amruth A. Alluri, BA², Yashaswi Guntupalli, MBBS³, Nikhil Patel Pokar, MBBS⁴, Tirth Patel, MBBS⁴
1HCA Medical City Healthcare UNT-TCU GME (Arlington), Arlington, TX; 2American University of the Caribbean School of Medicine, Miami, FL; 3Sri Padmavathi Medical College for Women, SVIMS, Tirupati, Tirupati, Andhra Pradesh, India; 4Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India

Introduction: Timely follow-up after a positive Hepatitis C virus (HCV) antibody test is essential for diagnosis confirmation via HCV RNA testing and initiation of treatment. Language discordance between patients and primary care providers (PCPs) may act as a barrier to appropriate follow-up. This multi-center study examines the association between patient-provider language discordance and follow-up rates with hepatology and/or gastroenterology specialists after a positive HCV antibody test.

Methods: We conducted a retrospective chart review across three urban primary care clinics from 2022 to 2024. The study cohort included 317 patients aged 45–70 with first-time positive HCV antibody screening and private or public insurance. Patients were categorized based on language concordance with their PCP (English vs. non-English primary language). Exclusion criteria included prior known HCV diagnosis, loss to follow-up due to death, incarceration, or relocation. Outcomes measured were: 1) completion of confirmatory HCV RNA testing, 2) attendance at specialist follow-up within 6 months, and 3) time to specialist follow-up. Data were gathered from electronic health records, specialist reports, and patient follow-up calls.

Results: Of the 317 patients with a positive HCV antibody screen, 201 (63.4%) had language-concordant PCPs and 116 (36.6%) had language-discordant PCPs. HCV RNA confirmatory testing was completed in 88% of the concordant group versus 70% in the discordant group (p< 0.001). Among those with positive RNA, 76% (96/126) of language-concordant patients saw a specialist within 6 months, compared to 58% (39/67) of language-discordant patients (p< 0.001), yielding an adjusted odds ratio of 2.3 (95% CI: 1.4–3.9). Median time to specialist visit was shorter in the concordant group (45 days, IQR: 31–60) than the discordant group (58 days, IQR: 44–76; p< 0.001). Differences were more pronounced in Medicaid patients (concordant 72% vs. discordant 49%, p< 0.001) than those with private insurance (concordant 81% vs. discordant 75%, p=0.11).

Discussion: Language concordance between PCPs and patients was significantly associated with higher rates of confirmatory testing and specialist follow-up after a positive HCV screen. Disparities were amplified in publicly insured populations, suggesting that language barriers may compound systemic access limitations. Targeted communication interventions are critical for improving equity in HCV care.

Disclosures:
Jason Truong indicated no relevant financial relationships.
Amruth Alluri indicated no relevant financial relationships.
Yashaswi Guntupalli indicated no relevant financial relationships.
Nikhil Patel Pokar indicated no relevant financial relationships.
Tirth Patel indicated no relevant financial relationships.

Jason C. Truong, DO, MS¹, Amruth A. Alluri, BA², Yashaswi Guntupalli, MBBS³, Nikhil Patel Pokar, MBBS⁴, Tirth Patel, MBBS⁴. P5762 - The Impact of Language Discordance Between Primary Care Providers and Patients on Hepatitis C Follow-Up After Positive Screening: A Multi-Center Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.