Implementing a Comprehensive Hepatitis C Virus (HCV) Clinic Within a Human Immunodeficiency Virus Clinic: A Model of Care for HCV Microelimination

Rizk, Christina; Miceli, Janet; Shiferaw, Bethel; Malinis, Maricar; Barakat, Lydia; Ogbuagu, Onyema; Villanueva, Merceditas

doi:10.1093/ofid/ofz361

Cited by 25 publications

(44 citation statements)

References 32 publications

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“…NHS Tayside's integrated multistakeholder care pathway for HCV among PLHIV has been key to progressing microelimination in this cohort, with BBV tests being conducted in nine different services (Figure 1). Integrating care pathways for HCV have been successful in several discrete settings, 30‐32 and this study adds to the evidence for co‐location HCV care in related services at a regional level. Routine HCV testing among PLHIV through diverse services ensures ongoing monitoring of primary and reinfection.…”

Section: Discussionmentioning

confidence: 82%

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real‐world outcomes

Byrne

Emma

Rae

et al. 2020

Health Science Reports

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Background and aims NHS Tayside is a health board in Scotland which serves around 400 000 residents. Approximately, 2761 are estimated to be persons who inject drugs (PWID), and therefore at risk of infections such as hepatitis C (HCV) and HIV. There are few studies exploring mechanisms and success of eliminating HCV in HIV co‐infected PWID using real‐world data. This study aims to empirically assess HCV treatment outcomes in people living with HIV (PLHIV) to evaluate progress toward microelimination of HCV in the HIV‐positive population in Tayside. Methods HCV testing and treatment details for PLHIV stored on clinical databases dating from 2001 were extracted and anonymized. HCV treatment uptake among co‐infected patients eligible for HCV treatment was calculated. Reinfection incidence was calculated in person years. Confidence intervals were calculated assuming Poisson distribution. Caldicott Guardian approval was obtained to access patient data (ref: IGTCAL 5677). Results Ninety‐six percent of PLHIV were tested for HCV across nine services and aware of their HCV status. From 2001 to 2019, 58 PLHIV were HCV co‐infected. Four left the area and five died prior to HCV treatment. Forty‐nine were eligible for HCV treatment. Thirty were treated with PEGylated interferon (Peg‐IFN); 18 with direct acting antivirals (DAA). One is yet to be treated. Twelve treated with Peg‐IFN did not achieve sustained viral response (SVR12); 10 were retreated, two died prior to re‐treatment. Injecting drug use was the mode of HCV transmission for 39 of 49 patients. Proportion who achieved SVR12 is 75%; 92% if treated with DAAs. Annual proportions of PLHIV treated for HCV increased from 3.57% in the Peg‐IFN era to 66.67% in the DAA era. Reinfection incidence is 0.2 per 100 person years (CI −0.3 to 0.7). Conclusions NHS Tayside has made progress toward microelimination of HCV among PLHIV. The most common mode of HCV transmission in PLHIV in NHS Tayside is injecting drug use. DAAs increased the proportion of co‐infected PLHIV treated for HCV and produced superior SVR12 results compared to Peg‐IFN.

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Section: Discussionmentioning

confidence: 82%

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real‐world outcomes

Byrne

Emma

Rae

et al. 2020

Health Science Reports

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“…Both are designed to provide population-based data on Veterans Affairs patients infected with HIV or HCV, which share common risk factors[ 66 ]. Rizk et al[ 67 ] (2019) highlight how disease registries enable follow-up and allow identification of barriers to care, with innovative solutions such as co-located HIV and HCV clinics being developed as a result.…”

Section: Recommendations To Eliminate Hcv Burden In Kuwaitmentioning

confidence: 99%

Accelerating the elimination of hepatitis C in Kuwait: An expert opinion

Hasan

Alfadhli

Al-Gharabally

et al. 2020

WJG

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The hepatitis C virus (HCV) is estimated to affect 71 million people worldwide. In 2016, the World Health Organization adopted the first global health sector strategy to eliminate viral hepatitis as a public health threat by 2030. In December 2018, the European Association for the Study of the Liver, International Liver Foundation convened an expert panel to address the elimination of HCV in Kuwait. Several steps have already been taken to eliminate HCV in Kuwait, including free HCV treatment for Kuwait’s citizens, high blood safety standards, and the implementation of screening and awareness programs. The expert panel made several recommendations aimed at accelerating the elimination of HCV in Kuwait: The development of a national strategy and action plan to guide all HCV elimination activities; the formation of a coordination mechanism to support collaboration between hepatitis working committees; the prioritization of micro-elimination at primary, secondary or tertiary facilities, in prisons and rehabilitation centers; and ensuring the involvement of multiple stakeholders – including relevant civil society groups – in all activities. Enhanced screening and linkage to care should be prioritized in Kuwait, with the expansion of the prescriber base to primary healthcare providers and nurse practitioners to be considered. Raising awareness and educating people about HCV infection also remain essential to achieve the goal of HCV elimination. Lastly, a national HCV registry should be developed to help monitor the implementation of viral hepatitis plans and progress towards achieving national and international targets.

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“…Eleven studies co-located HCV treatment point of care with other services. These services included primary care services [36,41,42], homeless primary care services [26], SAM clinics [41,43,44], harm reduction centers [45][46][47], public health services [48], and HIV clinics [49].…”

Section: Co-locationmentioning

confidence: 99%

“…Clinical Visits Follow-up support to ensure adherence was the most addressed component within this dimension (19 studies). This follow-up was offered by providers [31,33,37,39,40,42,43,45,46,48,[50][51][52]58] as well as peer support groups [26,53,56]. One study triaged the patients into different levels of support according to their risk of non-adherence and patients who did not complete treatment were offered intensive follow-up home visits by peers [57].…”

Section: Follow-up and Adherence Support For Requiredmentioning

confidence: 99%

“…Coordinating treatment plans was implemented by linking HCV services with medical and social services in [23, 25, 27-30, 38, 39, 43, 49, 58] 11 Specific relevance of patient centeredness to treatment outcomes [26, 28-37, 39, 41-43, 45, 47, 50-57] two studies [33,39], mental health and SAM services in three studies [35,40,51], specialty pharmacy [43], and other organizations for medication support [31].…”

Section: Coordinated Hcv Treatment Plan With Other Servicesmentioning

confidence: 99%

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Patient Centeredness in Hepatitis C Direct-Acting Antiviral Treatment Delivery to People Who Inject Drugs: A Scoping Review

Abdelwadoud

Mattingly

Seguí

et al. 2020

Patient

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Background and Objective Patient-centered care (PCC) is crucial for value-based care. We aimed to assess PCC dimensions addressed in hepatitis C virus direct-acting antiviral treatment delivery to people who inject drugs. Methods We conducted a scoping review to identify the studies that described hepatitis C virus treatment delivery to people who inject drugs in the direct-acting antiviral treatment era. We analyzed the included studies against eight PCC dimensions: (1) access to care; (2) coordination and integration of care; (3) continuity and translation; (4) physical comfort; (5) information, education, and communication; (6) emotional support; (7) involvement of family and friends; and (8) respect for individual patient preferences, perceived needs, and values. Additionally, we assessed the use of patient-centered terminology and the recognition of PCC importance and its relevance to treatment outcomes. Results None of the identified 36 studies addressed all PCC dimensions (highest seven, lowest two). Our findings revealed that PCC dimensions are prioritized differently and addressed using different approaches and strategies. Studies that used PCC terminology referred to personalized activities, which does not imply comprehensive PCC. About one-third of the studies acknowledged the importance of patient centeredness and two-thirds recognized its relevance to treatment outcomes. Conclusions Our findings suggest more engagement of people who inject drugs and comprehensive involvement of their families and friends in hepatitis C virus treatment journey, decisions, and outcomes. The recognition of PCC importance and its relevance to treatment outcomes in the analyzed studies emphasizes the need for more patient-centered hepatitis C virus treatment for people who inject drugs. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-020-00489-6.

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Implementing a Comprehensive Hepatitis C Virus (HCV) Clinic Within a Human Immunodeficiency Virus Clinic: A Model of Care for HCV Microelimination

Cited by 25 publications

References 32 publications

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real‐world outcomes

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real‐world outcomes

Accelerating the elimination of hepatitis C in Kuwait: An expert opinion

Patient Centeredness in Hepatitis C Direct-Acting Antiviral Treatment Delivery to People Who Inject Drugs: A Scoping Review

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