Community-based HCV treatment lessens burden on specialists

Issue: May 2016

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

“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 multicenter, open label, phase 4 study sponsored by the NIH, included patients receiving nonrandomized treatment from a specialist in infectious disease or hepatology, a PCP 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), PCPs 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)

“The data presented here are extremely welcome and show 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, vice secretary for the European Association for the Study of the Liver, said in the 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.