Linkage to care following referral continues to be a challenge for the hepatitis C virus (HCV) cascade of care (CoC) during the direct acting antiviral (DAA) era, a recent study suggests. The single-center cohort study consisted of patients receiving care in an outpatient infectious diseases clinical between October 2015 and September 2016. Patients were followed from treatment referral through sustained viral response (SVR). Researchers performed univariate and multivariate analyses to identify factors related to completion of each step of the CoC. They found:
- Of 187 patients meeting inclusion criteria, 120 (64%) completed an evaluation for HCV treatment, 119 (64%) were prescribed treatment, 114 (61%) were approved for treatment, 113 (60%) initiated treatment, 107 (57%) completed treatment, and 100 (53%) achieved SVR.
- Patients with Medicaid insurance were less likely to complete an evaluation and were less likely to be approved for treatment.
- Treatment completion and SVR rates are much improved from historical CoC reports.
Zuckerman A, Douglas A, Nwosu S, Choi L, Chastain C. Increasing success and evolving barriers in the hepatitis C cascade of care during the direct acting antiviral era. [Published online ahead of print June 18, 2018]. PLoS One. doi:10.1371/journal.pone.0199174.
This Week's Must Reads
Intensive BP Control & Risk of Dementia, JAMA; ePub 2019 Jan 28; SPRINT MIND Investigators
Outpatient Care for Adults With Primary Care, JAMA Intern Med; ePub 2019 Jan 28; Levine, et al
Antibiotic Therapy in Patients with Asthma, JAMA Intern Med; ePub 2019 Jan 28; Stefan, et al
Outpatient Benzodiazepine Prescribing in US, JAMA Netw Open; 2019 Jan 25; Agarwal, et al
Reduction of Readmissions Through Primary Care, JAMA Netw Open; 2019 Jan 25; Wiest, et al
Must Reads in Hepatitis
Glecaprevir/Pibrentasvir Efficacy & Safety Assessed, J Hepatol; ePub 2018 Nov 23; D’Ambrosio, et al
HCV Infection Among Children & Young Persons, J Hepatol; ePub 2018 Nov 26; Modin, et al
HCV Patients with Limited Access to Antiviral Therapy, Dig Liver Dis; ePub 2018 Nov 29; Lens, et al
Progression in the Elimination of HCV Infection, PLoS One; ePub 2018 Dec 4; Juanbeltz, et al
Increased HCV Screening in Veteran Populations, Jt Comm J Qual Patient Saf; ePub 2018 Sep 25; Wray, et al