Jiang Shirley X, Feizi Jeanette, Chan Brandon, Tam Edward, MacIsaac Julia, Ko Hin Hin, Ramji Alnoor
Department of Medicine, Post Graduate Medical Education, University of British Columbia, Vancouver, British Columbia, Canada.
Gastrointestinal Research Institute, Vancouver, British Columbia, Canada.
Can Liver J. 2025 Feb 25;8(1):29-38. doi: 10.3138/canlivj-2024-0016. eCollection 2025 Feb.
The COVID-19 pandemic changed the landscape of hepatitis C virus (HCV) treatment in Canada. In this study, we sought to describe the characteristics, management, and outcomes of patients treated during the pandemic.
Retrospective analysis of the British Columbia HCV Network included HCV patients treated from March 17, 2018 to February 22, 2022. Patients who started treatment before and after March 17, 2020 were designated pre-pandemic and pandemic groups, respectively. Patients were followed until sustained virologic response 12 weeks post-treatment (SVR12).
A total of 851 patients underwent 854 treatments, with 481 (56%) pre-pandemic and 373 (44%) pandemic. Pandemic patients were younger (median age 57 versus 61 pre-pandemic; <0.01) and 23% were on opioid agonist therapy (versus 11% pre-pandemic; = 0.01). Fewer pandemic patients completed transient elastography (36% versus 56% pre-pandemic; < 0.01). Pandemic patients utilized fewer in-person appointments and more telehealth appointments ( < 0.01). Fewer pandemic patients completed treatment (85% versus 91% pre-pandemic; = 0.23); the SVR12 rate was 97.8% in those completing treatment and lab work (versus 99.5% pre-pandemic; < 0.01). Younger age, substance use, and opioid agonist therapy were associated with loss to follow-up during the pandemic.
Patients treated for HCV in British Columbia during the pandemic utilized fewer resources and had more loss to follow-up but maintained high SVR12 rates. Transitioning from in-person to telehealth appointments proved effective in a real-world setting. Individualized strategies are required for special populations prone to loss to follow-up.
新冠疫情改变了加拿大丙型肝炎病毒（HCV）的治疗格局。在本研究中，我们试图描述疫情期间接受治疗患者的特征、管理情况及治疗结果。
对不列颠哥伦比亚省HCV网络进行回顾性分析，纳入2018年3月17日至2022年2月22日期间接受治疗的HCV患者。2020年3月17日之前和之后开始治疗的患者分别被指定为疫情前组和疫情组。对患者进行随访，直至治疗后12周持续病毒学应答（SVR12）。
共有851例患者接受了854次治疗，其中疫情前组481例（56%），疫情组373例（44%）。疫情期间的患者更年轻（中位年龄57岁，而疫情前为61岁；P<0.01），23%的患者接受阿片类激动剂治疗（疫情前为11%；P = 0.01）。接受瞬时弹性成像检查的疫情期间患者较少（36%，而疫情前为56%；P < 0.01）。疫情期间患者的面对面预约较少，远程医疗预约较多（P < 0.01）。完成治疗的疫情期间患者较少（85%，而疫情前为91%；P = 0.23）；完成治疗和实验室检查的患者中SVR12率为97.8%（而疫情前为99.5%；P < 0.01）。年龄较小、药物使用和阿片类激动剂治疗与疫情期间失访有关。
疫情期间在不列颠哥伦比亚省接受HCV治疗的患者使用的资源较少，失访情况较多，但SVR12率保持较高。在现实环境中，从面对面预约过渡到远程医疗预约被证明是有效的。对于容易失访的特殊人群，需要采取个性化策略。
