Q&A: Diagnosing new HCV infections more challenging during COVID-19 pandemic
It has been well over year since the COVID-19 pandemic began, and all aspects of health care have been impacted in various ways.
WHO’s goal to eliminate viral hepatitis by 2030 was also affected. The pandemic made it difficult to diagnose new infections and allow these patients to begin necessary treatment.
Healio Gastroenterology spoke with Sunil S. Solomon, MBBS, associate professor from the John Hopkins School of Medicine, about how COVID-19 has impacted his research on hepatitis C virus and the field of hepatology as a whole.
Healio: How has COVID-19 impacted your work in HCV research?
Solomon: We have had to incorporate strategies to minimize risk for SARS-CoV-2 acquisition for study participants and research teams – in many cases, this has resulted in refabricating research sites to incorporate plexiglass, personal protective equipment for all staff and pre-screens for COVID-19 symptoms over phone prior to in-person visits. We have also had to pause research due to lockdowns and travel restrictions and re-think ways of delivering care with minimal in-person contact.
For example, one of the strategies we’re investigating was directly observed therapy of direct-acting antivirals coupled with medication for opioid use disorder but this is no longer feasible (at least currently) in a safe way and so we are transitioning to field-based delivery and video directly observed therapy when participants have cell phones.
Healio: Has COVID-19 impacted the field of hepatology?
Solomon: COVID-19 resulted in people delaying care and skipping routine visits to the hospital either due to travel restrictions or fear of contracting COVID. In terms of HCV, this has probably set us back in the diagnosis of new infections and getting them on treatment, which is critical for HCV elimination.
The same is the case for other chronic liver diseases as well. There have been reports of increases in alcohol consumption during these stay-at-home and lockdown orders, which has probably contributed to progression of liver disease especially among cirrhotics that we will begin to see when routine care visits resume.
Healio: Did dealing with the COVID-19 crisis changed aspects of patient care for the better?
Solomon: COVID-19 has really highlighted the role of telemedicine and the ability to deliver quality care with minimal face-to-face contact especially for non-cirrhotics who are infected with HCV. Coupled with the findings of the MINMON trial, it is not far-fetched to believe that we could potentially cure a large majority of people living with HCV without ever seeing them in-person. The challenge is going to be increasing diagnosis.