May 11, 2020
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HCV treatment through telehealth highly effective regardless of DAA regimen

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Using the American Association for the Study of Liver Diseases and Infectious Diseases Society of America guidelines, treatment for HCV in the Department of Corrections through telehealth was highly effective with an overall sustained virologic response of 97%, regardless of underlying genotype or direct-acting antivirals regimen used, according to data from Digestive Disease Week.

“Treating HCV in prisons through telemedicine offers the opportunity to treat high risk patients and by eliminating HCV in the microenvironment, we can reduce the overall burden of HCV in our environment,” Taseen A. Syed, MD, first year gastroenterology fellow at Virginia Commonwealth University, said during his virtual presentation.

Syed and colleagues had developed a telehealth HCV referral, assessment and direct-acing antiviral treatment protocol with the Virginia Department of Corrections using the AASLD and IDSA guidelines for disease severity, genotype and prior treatment experience. From June 15 to October 2019, 872 DOC patients were assessed, 672 of whom completed HCV therapy with sustained virologic response (SVR-12). Investigators prospectively collected demographic, clinical and laboratory data.

Patients were seen before treatment and at 4 weeks, end of treatment and at 12 weeks follow-up for SVR-12. Prior to beginning DAA, patients with advanced fibrosis (stage 3-4, defined by FIB-4 3.25 and/or vibration controlled transient elastography 9.5 kPa) underwent ultrasound to exclude hepatocellular carcinoma. Investigators compared differences between treatment regimens.

Results showed 79% of patients had genotype 1, 92% were treatment naive and 80% had advanced fibrosis. Investigators noted most patients received treatment for 12 weeks and 25% of patients received ribavirin plus a DAA. The SVR-12 was 97%. Overall SVR-12 was similar among the DAA regimens and was not affected by age, sex, race, HIV status, fibrosis level, genotype, ribavirin use, prior treatment experience or DAA duration.

“With more than 30,000 individuals in the Virginia DOC, about one-third may have HCV,” Syed said. “This offers a ‘captive’ population to treat to reduce HCV in the prison microenvironment thus reducing the overall HCV burden upon release.” – by Monica Jaramillo

Reference: Syed TA, et al. Abstract 869. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).

Disclosure: Tassen reports no relevant financial disclosures. Please see the study abstract for all other authors’ relevant financial disclosures..