‘We must redouble our efforts’: More signs HCV care has suffered during pandemic
Because of pandemic-related disruptions in hepatitis C care, researchers said thousands of cases will remain unidentified with fewer patients initiating care and achieving SVR.
“The combination of lockdowns and stay in place orders, health care facilities pausing different clinical services and the need to divert resources to COVID-19 meant that trajectories for different diseases were altered. We saw this happen with services for HIV, malaria, and tuberculosis worldwide,” Joshua A. Barocas, MD, associate professor of medicine at the University of Colorado School of Medicine, told Healio.
“We had a hypothesis that the trajectory of HCV in the population would also be altered,” Barocas said. “We felt like it was important to understand the possible long-term impact of COVID-19 on the hepatitis C epidemic in the United States.”
Barocas and colleagues used a microsimulation to estimate the 10-year impact of COVID-19 disruptions in health care delivery on HCV outcomes, including infections, linkage to care, treatment initiation and completion, cirrhosis and liver-related death.
They modeled hypothetical scenarios consisting of an 18-month pandemic-related disruption in HCV care starting in March 2020, followed by varying returns to prepandemic rates of screening, linkage and treatment through March 2030, and compared them with a counterfactual scenario in which there was no COVID-19 pandemic or disruptions in care.
In the scenario during which there is no return to prepandemic levels of HCV care, the researchers calculated 1,060 fewer identified cases, of which only 3% initiate treatment and less than 1% achieve SVR. Additionally, 21 additional cases of cirrhosis and 16 additional liver-related deaths per 100,000 people would be reported compared with the “no pandemic” scenario, they said.
Based on these findings, Barocas and colleagues said there needs to be a recommitment to the HCV epidemic in the U.S. to overcome COVID-19-related disruptions. Other projects also have shown pandemic-related impacts to HCV care.
“The COVID-19 pandemic caused an unparalleled disruption in health care service delivery. Vulnerable populations in the U.S. including those with and at risk for HCV are likely to experience worse outcomes as a result,” Barocas said. “We must redouble our efforts and commit additional resources to screen, link and treat people with HCV. Without doing so, we are likely to endure the HCV epidemic for many years to come.”