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Community-based HCV treatment lessens burden on specialists

BARCELONA — Moving treatment for hepatitis C virus infection into community practices may lighten the load currently felt by HCV specialists without sacrificing health of the patients, according to a study presented in a Late Breaker poster at the International Liver Congress 2016.

“With such a large patient cohort, ensuring that patients can access safe, effective and appropriate treatment is essential,” Sarah Kattakuzhy, MD, assistant professor at the Institute of Human Virology at the University of Maryland School of Medicine, said in a press release. “Currently, the limited availability of experienced specialists restricts rapid expansion of hepatitis C treatment, compromising the goal of global eradication. As such, care models which bypass this therapeutic bottleneck must be explored.”

This multi-center, open label, phase 4 study sponsored by the National Institutes of Health, included patients receiving non-randomized treatment from a specialist in infectious disease or hepatology, a primary care physician or a nurse practitioner, all of whom participated in a 3-hour training on the HCV Guidelines. Patients, in turn, received the same treatment with Harvoni (ledipasvir/sofosbuvir, Gilead Sciences).

Of the 304 patients with available results, 285 patients achieved sustained virologic response at 12 weeks. Broken down by treatment provider, specialists achieved SVR12 in 92.1% of patients (152/165), primary care physicians did so in 96.7% (58/60) and nurse practitioners in 94.9% (75/79). Of 409 patients who completed 12 weeks of therapy, visit adherence was lower in the specialists’ practices (P < .001).

Tom Hemming-Karisen

“The data presented here is extremely welcome and shows great potential to escalate treatment options and protocols for hepatitis C. We have the therapies, we now need to make sure we can effectively roll them out to patients,” Tom Hemming-Karisen, MD, PhD, EASL Vice-Secretary, said in a press release. “We know we have too few experienced specialists treating HCV and this is severely hampering our ability to eradicate this disease once and for all. This research has the potential to be a genuine game changer in the way we look at HCV treatment across the board, and could provide the opportunity to increase access to care and treatment to many regions of the world.” – by Katrina Altersitz

Reference:

Kattakuzhy S, et al. Abstract LBP524. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.

Disclosure: The researchers report no relevant financial disclosures.