Start antiviral treatment Hepatitis C virus (HCV) Follow-up care via telemedicine during a hospital stay increases the likelihood that addicts will complete the treatment process and be cured, according to findings published in the journal 2017. Journal of General Internal Medicine.
“This model successfully engages a hard-to-reach patient population with high prevalence and incidence of HCV infection,” concluded L. Madeline McCrary, MD, PhD, of the University of North Carolina at Chapel Hill, and colleagues. “This approach may Applicable to other hospitalized patients with HCV who have a longer hospital stay.”
People who inject drugs are Higher risk of contracting hepatitis C, making them a target group for direct-acting antiviral therapy. However, providing treatment and ensuring it is completed can be difficult. In the past, researchers have found that HCV testing at safe injection sites and Combine testing with caution has shown promising results.
McCrary and colleagues sought to improve retention in hepatitis C treatment among hospitalized injecting drug users. Their primary outcome was treatment completion, but the researchers also noted whether participants received an e-counseling appointment, whether it was linked to care, whether treatment was initiated, and whether treatment was successful.
First, the researchers analyzed care for injection drug users who were hospitalized at the University of North Carolina Medical Center and diagnosed with hepatitis C virus. During the study period from August 2021 to August 2022, 28 people were found to have detectable HCV RNA, indicating active infection. The average age is 33, and 82% are white.
These individuals were initially admitted to the hospital for conditions such as osteomyelitis and endocarditis, which required extensive antibiotic treatment, with an average length of stay of 23 days. Nearly two-thirds (61%) are uninsured and require antiviral medications subsidized by drug manufacturers. About 93% of people begin treatment for opioid use disorder while hospitalized.
The team identified several gaps in care pathways, including insufficient testing, lack of access to HCV treatment for the uninsured and a lack of transportation to appointments. In response, researchers developed a protocol to ensure testing and vaccinations were completed during hospitalization. In addition, they completed paperwork for patients to ease the transition to telehealth after discharge. As part of the e-consultation phase, the team analyzes lab reports, performs imaging, prescribes medications and recommends any other required testing and vaccinations.
Of the 28 participants, 82% received care and 73% started HCV antiviral treatment. Eleven started hepatitis C treatment while hospitalized, 8 started treatment after discharge, and 9 were lost to follow-up or transferred elsewhere for treatment. Overall, of the 19 patients who started antiviral therapy, 52% completed treatment.
Of the 11 patients who initiated HCV treatment during hospitalization, 8 (73%) completed treatment, with the majority achieving a sustained virological response or undetectable HCV RNA at 12 weeks after treatment completion. Considered healing. In contrast, of the 17 participants who did not start HCV treatment in the hospital, 12 (71%) received care, 8 (53%) started ART, 5 (36%) completed treatment, and 4 The name cures.
“Initiating hepatitis C treatment during hospitalization is feasible and effective for curing hepatitis C in patients with injection drug-related complications,” the researchers wrote. “Our model suggests that inpatient care coordination and, when possible, inpatient initiation of direct action Antiviral drugs can increase treatment initiation and cure rates.”
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