Chen Phillip Huang, Truong Justin, Kawamoto Jenna, Bhattacharya Debika, Patel Arpan
David Geffen School of Medicine, University of California, Los Angeles.
Veterans Affairs Greater Los Angeles Healthcare System.
Fed Pract. 2024 Mar;41(3):88-92. doi: 10.12788/fp.0460. Epub 2024 Mar 15.
The COVID-19 pandemic has presented challenges for hepatitis C virus (HCV) treatment given the need for thorough evaluation by specialists, treatment coordination, follow-up visits, laboratory monitoring, and potential health behavior impacts on patients. The objective of this study was to evaluate HCV treatment during the beginning of the COVID-19 pandemic, when care was conducted virtually, by examining patient demographics associated with treatment initiation and discontinuation rates.
This retrospective study included 73 patients with quantifiable HCV RNA evaluated by gastroenterologists and infectious disease clinicians and referred to an HCV clinical pharmacy team for treatment coordination from March 1, 2020, to September 30, 2020. Data collection included baseline demographics, clinical characteristics, and treatment characteristics. Patients were followed until June 15, 2021.
Forty-three patients (59%) initiated HCV treatment while 30 patients (41%) did not. Patient demographics were not associated with HCV treatment initiation rates except for presence of alcohol use disorder within the past 6 months ( = .003). Of the 43 patients that initiated HCV treatment, 9 patients (21%) discontinued their treatment. Twenty-two of 25 patients (88%) with laboratory analysis achieved sustained virologic response. There were no demographic or geographic disparities between patients that initiated HCV treatment and those that did not during the study period.
Results of this study suggest that active alcohol use disorder diagnosis may be associated with HCV treatment noninitiation. This study emphasizes the need for further research to define the standards of care in assessing active alcohol use disorder during HCV treatment evaluation.
鉴于需要专家进行全面评估、治疗协调、随访、实验室监测以及潜在的健康行为对患者的影响，新冠疫情给丙型肝炎病毒（HCV）治疗带来了挑战。本研究的目的是通过检查与治疗启动和停药率相关的患者人口统计学特征，评估在新冠疫情初期以虚拟方式进行治疗时的HCV治疗情况。
这项回顾性研究纳入了73例丙型肝炎病毒核糖核酸（HCV RNA）可量化的患者，这些患者由胃肠病学家和传染病临床医生进行评估，并于2020年3月1日至2020年9月30日转介至HCV临床药学团队进行治疗协调。数据收集包括基线人口统计学、临床特征和治疗特征。对患者进行随访至2021年6月15日。
43例患者（59%）开始了HCV治疗，而30例患者（41%）未开始治疗。除过去6个月内存在酒精使用障碍外（P = .003），患者人口统计学特征与HCV治疗启动率无关。在开始HCV治疗的43例患者中，9例患者（21%）停止了治疗。25例进行实验室分析的患者中有22例（88%）实现了持续病毒学应答。在研究期间，开始HCV治疗的患者与未开始治疗的患者之间在人口统计学或地理方面没有差异。
本研究结果表明，酒精使用障碍的诊断可能与未开始HCV治疗有关。本研究强调需要进一步研究以确定在HCV治疗评估中评估酒精使用障碍的护理标准。
