Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria.
J Viral Hepat. 2022 Dec;29(12):1062-1072. doi: 10.1111/jvh.13746. Epub 2022 Sep 12.
The COVID-19 pandemic necessitates healthcare restrictions that also affected ongoing hepatitis C virus (HCV) elimination efforts. We assessed the value of a physician-operated HCV hotline on treatment and cure rates throughout the pandemic. All HCV patients undergoing HCV therapy at the Vienna General Hospital from 2019 to 2021 were included. An HCV hotline was established in 2019 and provided services including phone calls, text messages and voicemails. Patients were stratified by date of HCV therapy: 2019 (pre-COVID) vs. 2020/2021 (during-COVID) and use of the HCV hotline: users vs. non-users. Overall, 220 patients were included (pre-COVID: n = 91 vs. during-COVID: n = 129). The prevalence of intravenous drug use (60.5%) and alcohol abuse (24.8%) was high during COVID. During COVID, the number of DAA treatment starts declined by 24.2% (n = 69) in 2020 and by 34.1% (n = 60) in 2021 vs. pre-COVID (n = 91, 100%). Significantly more patients used the HCV hotline during-COVID (95.3%) vs. pre-COVID (65.9%; p < .001). Sustained virologic response (SVR) was 84.6% pre-COVID and 86.0% during-COVID. HCV hotline users achieved higher SVR rates during-COVID (88.2% vs. 33.3%, p = .004), but also pre-COVID (96.7% vs. 61.3%, p < .001) compared with non-users. Considering only patients with completed DAA treatments, SVR rates remained similarly high during-COVID (96.9%) versus pre-COVID (98.1%). HCV treatment initiations decreased during-COVID but importantly, nearly all DAA-treated HCV patients used the HCV hotline during the COVID pandemic. Overall, the SVR rate remained at 88.2% during COVID and was particularly high in HCV phone users-most likely due to facilitation of adherence.
新型冠状病毒病大流行需要实施医疗限制，这也影响了正在进行的丙型肝炎病毒 (HCV) 消除工作。我们评估了医生运营的 HCV 热线在整个大流行期间对治疗和治愈率的价值。2019 年至 2021 年期间，在维也纳综合医院接受 HCV 治疗的所有 HCV 患者均被纳入研究。2019 年建立了 HCV 热线，并提供了电话、短信和语音邮件服务。患者按 HCV 治疗日期分层：2019 年（COVID-19 前）与 2020/2021 年（COVID-19 期间），以及 HCV 热线的使用情况：使用者与非使用者。共有 220 名患者被纳入研究（COVID-19 前：n=91 与 COVID-19 期间：n=129）。在 COVID-19 期间，静脉药物使用（60.5%）和酒精滥用（24.8%）的患病率很高。在 COVID-19 期间，2020 年 DAA 治疗开始的数量减少了 24.2%（n=69），2021 年减少了 34.1%（n=60），与 COVID-19 前（n=91，100%）相比。在 COVID-19 期间，明显有更多的患者使用了 HCV 热线（95.3%），而 COVID-19 前（65.9%）（p<.001）。COVID-19 前 HCV 患者的持续病毒学应答率（SVR）为 84.6%，COVID-19 期间为 86.0%。HCV 热线使用者在 COVID-19 期间获得了更高的 SVR 率（88.2%比 33.3%，p=0.004），而在 COVID-19 前也获得了更高的 SVR 率（96.7%比 61.3%，p<.001）。仅考虑完成 DAA 治疗的患者，COVID-19 期间的 SVR 率仍然很高（96.9%比 COVID-19 前（98.1%）。在 COVID-19 期间，HCV 治疗的启动减少了，但重要的是，几乎所有接受 DAA 治疗的 HCV 患者在 COVID 大流行期间都使用了 HCV 热线。总体而言，SVR 率在 COVID-19 期间保持在 88.2%，在 HCV 电话使用者中特别高-很可能是由于促进了依从性。
