A contactless cure: Leveraging telehealth to improve hepatitis C treatment at a safety-net hospital

J Viral Hepat. 2024 Apr;31(4):176-180. doi: 10.1111/jvh.13913. Epub 2024 Feb 18.

Abstract

Hepatitis C virus (HCV) causes significant mortality worldwide. HCV is highly curable but access to care is limited for many patients. The Grady Liver Clinic (GLC), a primary care-based HCV clinic, utilizes a multidisciplinary team to provide comprehensive care for a medically underserved patient population in Atlanta, Georgia. The GLC added a telehealth option for HCV treatment at the start of the COVID-19 pandemic. We describe the outcomes of utilizing telehealth in this population. We performed a retrospective chart review of patients who initiated HCV treatment from March 2019 to February 2020 (pre-pandemic) and March 2020 to February 2021 (pandemic). Charts were abstracted for patient demographics and characteristics, treatment regimen, and treatment outcomes. Our primary outcome was HCV cure rate of the pre-pandemic compared to the pandemic cohorts and within the different pandemic cohort visit types. We performed an intention-to-treat (ITT) analysis for all patients who took at least one dose of a direct-acting antiviral (DAA) regardless of therapy completion, and a per-protocol (PP) analysis of those who completed treatment and were tested for HCV cure. SVR12 rates were >95% on ITT analysis, with no significant difference between pre-pandemic and pandemic cohorts. There was also no significant difference within the pandemic group when treatment was provided traditionally, via telehealth, or via a hybrid of these. Our findings support the use of telehealth as a tool to expand access to HCV treatment in a medically underserved patient population.

Keywords: chronic disease; hepatitis C; telemedicine; urban population; vulnerable populations.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Hepacivirus
  • Hepatitis C* / drug therapy
  • Hepatitis C* / epidemiology
  • Hepatitis C, Chronic* / drug therapy
  • Humans
  • Pandemics
  • Retrospective Studies
  • Safety-net Providers
  • Telemedicine*

Substances

  • Antiviral Agents