Public Health Clinic–Based Hepatitis C Treatment

Rosecrans, Amanda; Cheedalla, Aneesha; Rives, Sarah; Scotti, Lisa A.; Harris, Robert S.; Greenbaum, Adena; Irvin, Risha; Ntiri-Reid, Boatemaa; Brown, Holly; Alston, Karen E.; Smith, Jaeson A.; Page, Kathleen R.; Falade‐Nwulia, Oluwaseun

doi:10.1016/j.amepre.2020.03.006

Cited by 5 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, in Baltimore city where this study took place, the Baltimore City Health Department has implemented programmes to increase access to testing and treatment for HCV at the health department sexually transmitted infection clinics and mobile‐based syringe service programmes, efforts which are intended to accelerate progress towards HCV elimination 56 . Partnerships among the Maryland Department of Health and Mental Hygiene, community‐based health centres, local health departments and academic institutions have also broadened the range of and practice settings of providers trained to provide hepatitis C treatment to include opioid treatment programmes and prison settings.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C treatment uptake among people who inject drugs in the oral direct‐acting antiviral era

Falade‐Nwulia

Gicquelais

Astemborski

et al. 2020

Liver International

View full text Add to dashboard Cite

Background: Increased uptake of hepatitis C virus (HCV) treatment among people who inject drugs (PWID) will be critical to achieve HCV elimination goals. There are limited data on HCV treatment uptake among PWID recruited from communitybased settings in the HCV direct-acting antiviral (DAA) era. Methods: We analysed data from PWID with HCV newly recruited into the Baltimore, Maryland-based AIDS Linked to the IntraVenous Experience (ALIVE) cohort between 2015 and 2018. We characterized the HCV care continuum and evaluated factors associated with HCV treatment uptake. Results: Of the 418 PWID with HCV, the median age was 49 years and most (88%) reported recent injection drug use (IDU). Overall, 23% had ever been evaluated by a provider for HCV treatment, 17% ever initiated DAA treatment and 13% were cured of HCV infection. Treatment uptake approximately doubled between 2015 and 2018 (13% to 26%, P = .01). In multivariable analyses, HIV infection (adjusted Odds Ratio [aOR] 2.5 [95% Confidence Interval (CI) 1.3, 4.8]), current employment (aOR 4.1 [CI 1.2, 14.4]), having a primary care provider (aOR 4.3 [CI 1.2, 14.9

show abstract

Section: Discussionmentioning

confidence: 99%

Hepatitis C treatment uptake among people who inject drugs in the oral direct‐acting antiviral era

Falade‐Nwulia

Gicquelais

Astemborski

et al. 2020

Liver International

View full text Add to dashboard Cite

show abstract

“…12 These community-based approaches have multiple benefi ts, including reduced stigmatization of marginalized communities and increased trust in local healthcare systems. 31,33,34 CONCLUSION Hepatitis C is an infectious disease affecting primarily vulnerable and at-risk populations who have multiple barriers to treatment. 10,17 Treatment has improved in effi cacy, safety, and ease of prescribing.…”

Section: Care Treatmentmentioning

confidence: 99%

“…The ASCEND trial published in 2017 found therapy by PCPs in urban federally qualified health centers to be safe and effective 42. By integrating hepatitis C treatment in sexual health clinics in Baltimore, Md., the clinics were able to improve HCV treatment access in underserved populations 31. The San Francisco Health Network implemented a successful primary care treatment model using specialty e-referrals for HCV treatment guidance, increasing treatment access for patients in marginalized populations 20…”

Section: Primary Care Treatmentmentioning

confidence: 99%

“…The availability of simplified treatment algorithms, the safety profile of direct-acting antiviral medications, and the potential for improved patient access all support the increased use of collaborative models to deliver hepatitis C treatment 12. These community-based approaches have multiple benefits, including reduced stigmatization of marginalized communities and increased trust in local healthcare systems 31,33,34…”

Section: Primary Care Treatmentmentioning

confidence: 99%

“…7,26 PCPs can effectively manage patients with uncomplicated hepatitis C infection in collaborative models with varying degrees of specialty support. 10,15,17,20,22,31,32 Traditionally, active substance abuse was a contraindication for HCV…”

Section: Managementmentioning

confidence: 99%

See 2 more Smart Citations

Improving hepatitis C screening and access to treatment

Alberts¹,

Zimmermann²,

Martinez³

2022

Jaapa

View full text Add to dashboard Cite

The rising prevalence of opioid use disorder and injection drug use has resulted in an increasing incidence of chronic hepatitis C virus (HCV) infection. Although older adults historically have represented the bulk of HCV infections in the United States, demographics have shifted and most new infections are presenting in younger patients. As a result, screening guidelines for HCV have evolved, moving toward a near-universal screening paradigm. Rates of screening and linkage to care remain low, attributed to the fact that underserved populations are disproportionately affected and often have limited access to specialty care. Collaborative models to treat HCV using primary care providers have been proposed to facilitate linkage to care and reduce transmission.

show abstract

Postpartum Hepatitis C Linkage to Care Program in a Co-located Substance Use Disorders Treatment Model

Cheedalla,

Hinely,

Roby

et al. 2023

Matern Child Health J

Self Cite

View full text Add to dashboard Cite

Purpose Hepatitis C virus (HCV) is increasingly prevalent in pregnancy and among people with substance use disorders (SUD). Highly effective treatments are now available for chronic HCV. Qualifying for HCV treatment often requires preauthorization and several clinical criteria, including laboratory assessment of liver function and other infectious diseases and liver imaging to assess for fibrosis. Linkage to care (LTC) models have been shown to assist with obtaining the necessary clinical information (laboratory assessment/liver imaging) and improving HCV treatment rates in non-pregnant individuals. Description Beginning in December 2020, a specialized LTC team identified patients with HCV viremia who were interested in postpartum treatment. The LTC team assisted patients with completing the necessary clinical criteria (laboratory assessment and liver imaging) for HCV treatment. Patients were then linked to infectious disease specialists who prescribed treatment to patients via telemedicine. Most patients identified with HCV were enrolled in our institution’s co-located obstetric and SUD program, which provides continued care until 1 year postpartum. Assessment In 2019, an internal review identified that none of the 26 pregnant patients with HCV viremia in our co-located obstetric and SUD program were prescribed direct-acting antiviral (DAA) treatment within 12 months postpartum. Between December 2020 and July 2022, our HCV LTC team identified 34 patients with HCV who were eligible for treatment. Of these patients, 55% (19/34) obtained all necessary laboratory and liver imaging requirements and 79% (15/19) were prescribed DAA treatment after a telehealth visit with an infectious disease specialist. All fifteen patients who were prescribed treatment participated in the co-located obstetric and SUD program. The largest barrier to obtaining treatment was completing the necessary laboratory and liver imaging requirements for prescribing DAA. Only one patient who did not receive care in our co-located obstetric and SUD program had completed the necessary laboratory and liver imaging requirements to proceed with treatment but did not follow up with the infectious disease specialist for DAA treatment. Conclusion Our HCV LTC program was successful in treating postpartum patients for HCV if they participated in the co-located obstetric and SUD program at our institution. Creating a partnership with an infectious disease specialist and utilizing telemedicine were beneficial strategies to connect patients to treatment for HCV during the postpartum period.

show abstract

Public Health Clinic–Based Hepatitis C Treatment

Cited by 5 publications

References 29 publications

Hepatitis C treatment uptake among people who inject drugs in the oral direct‐acting antiviral era

Hepatitis C treatment uptake among people who inject drugs in the oral direct‐acting antiviral era

Improving hepatitis C screening and access to treatment

Postpartum Hepatitis C Linkage to Care Program in a Co-located Substance Use Disorders Treatment Model

Contact Info

Product

Resources

About