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Barriers in the HCV Cascade of Care

PLoS One; ePub 2018 Jun 18; Zuckerman, et al

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.

Citation:

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.

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