Cascade of Care for Alaska Native People With Chronic Hepatitis C Virus Infection: Statewide Program With High Linkage to Care

McMahon, Brian J.; Townshend‐Bulson, Lisa; Homan, Chriss; Gounder, Prabhu; Barbour, Youssef; Hewitt, Annette; Bruden, Dana; Espera, Hannah; Plotnik, Julia; Gove, James; Stevenson, Timothy J.; Luna, Sarah V; Simons, Brenna C.

doi:10.1093/cid/ciz832

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…(33)(34)(35)(36) In recent years, government-affiliated health care systems, such as in the U.S. Department of Veterans Affairs, Cherokee Nation, and Alaskan Native Tribal Health Consortium, have demonstrated remarkable improvements in DAA access and uptake, illustrating the potential advantages of unified health delivery systems with relatively homogeneous patient populations. (37)(38)(39)(40) In the private sector, specialty clinics embedded within large health care organizations also have demonstrated the capacity to improve DAA access. During 2014 through 2017, cumulative DAA uptake among Kaiser Permanente Northern California patients with HIV/HCV coinfection was 70%.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Obstacles to Hepatitis C Treatment Initiation Among Patients in Care: A Hitch in the Cascade of Cure

et al. 2020

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for the Chronic Hepatitis Cohort Study (CHeCS) Investigators There are limited data examining the relationship between psychosocial factors and receipt of direct-acting antiviral (DAA) treatment among patients with hepatitis C in large health care organizations in the United States. We therefore sought to determine whether such factors were associated with DAA initiation. We analyzed data from an extensive psychological, behavioral, and social survey (that incorporated several health-related quality of life assessments) coupled with clinical data from electronic health records of patients with hepatitis C enrolled at four health care organizations during 2017-2018. Of 2,681 patients invited, 1,051 (39.2%) responded to the survey; of 894 respondents eligible for analysis, 690 (77.2%) initiated DAAs. Mean follow-up among respondents was 9.2 years. Compared with DAA recipients, nonrecipients had significantly poorer standardized scores for depression, anxiety, and life-related stressors as well as poorer scores related to physical and mental function. Lower odds of DAA initiation in multivariable analysis (adjusted by age, race, sex, study site, payment provider, cirrhosis status, comorbidity status, and duration of follow-up) included Black race (adjusted odds ratio [aOR], 0.59 vs. White race), perceived difficulty getting medical care in the preceding year (aOR, 0.48 vs. no difficulty), recent injection drug use (aOR, 0.11 vs. none), alcohol use disorder (aOR, 0.58 vs. no alcohol use disorder), severe depression (aOR, 0.42 vs. no depression), recent homelessness (aOR, 0.36 vs. no homelessness), and recent incarceration (aOR, 0.34 vs. no incarceration). Conclusion: In addition to racial differences, compared with respondents who initiated DAAs, those who did not were more likely to have several psychological, behavioral, and social impairments. Psychosocial barriers to DAA initiation among patients in care should also be addressed to reduce hepatitis C-related morbidity and mortality. (Hepatology Communications 2020;0:1-12). P ublic health prevention and control of hepatitis C entails identification of infected persons through universal testing, followed by linkage to clinical services and ensuring that persons linked to care receive and complete effective treatment. (1-5) On an individual level, eradication of hepatitis C virus (HCV) infection eliminates the possibility of HCV transmission to others and reduces morbidity and mortality from HCVattributable hepatic and extrahepatic disease among persons who no longer engage in transmission-associated behaviors. (4) Despite radical improvement in the treatment of HCV infection since the release of secondgeneration direct-acting antiviral (DAA) medications, uptake of these drugs in many U.S. general health care

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Section: Discussionmentioning

confidence: 99%

Psychosocial Obstacles to Hepatitis C Treatment Initiation Among Patients in Care: A Hitch in the Cascade of Cure

et al. 2020

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“…The initial search yielded 18,028 records in bibliographic databases and 194 records from other sources. After exclusion of duplicates and ineligible studies, 20 studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] were included in analysis (Figure 1).…”

Section: Re Sultsmentioning

confidence: 99%

“…Studies from Egypt, 13 Georgia, 14,32 Iceland, 15 the United States, [18][19][20]22,27 Canada, 21,23 the Netherlands, 29 Switzerland, 28 Australia, 30,31 Norway 16 and Denmark 16 provided additional components of the care cascade other than those HCV RNA positive and DAA treatment initiation (Tables S1 and S2).…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Sixteen studies reported the HCV care cascade among the general population with HCV in the United States, [17][18][19][20]22,24,25 Egypt, 13 Georgia, 14 Iceland, 15 Canada, 21,23 the Netherlands, 26 Sweden, 16 Norway 16 and Denmark. 16 The data from Egypt, Georgia, Iceland, Sweden and Norway were national level, while studies from the other countries reported data from one or multiple cities/provinces.…”

Section: Hcv Care Cascade Among General Populationmentioning

confidence: 99%

“…In most countries, access to DAA therapy in earlier years was restricted based on liver fibrosis stage and/or drug and alcohol use status while restrictions were lifted or eased in later years. [14][15][16][17][18]20,[24][25][26] Therefore, we ordered treatment uptake estimates by year of treatment uptake reported in each study (Figure 3). The forest plot showed higher treatment uptake in studies reporting data from more recent years.…”

Section: Hcv Care Cascade Among General Populationmentioning

confidence: 99%

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Global cascade of care for chronic hepatitis C virus infection: A systematic review and meta‐analysis

Yousafzai

Bajis

Alavi

et al. 2021

Journal of Viral Hepatitis

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The World Health Organization 2030 targets for hepatitis C virus (HCV) elimination include diagnosing 90% of people with HCV and treating 80% of people diagnosed with HCV. This systematic review assessed reported data on the HCV care cascade in various countries and populations, with a focus on direct-acting antiviral (DAA) treatment uptake. Bibliographic databases and conference presentations were searched for studies reporting the HCV care cascade (DAA treatment uptake was a requirement) among the overall population with HCV or sub-populations at greater risk of HCV. Population-based studies, with participants representative of a city, province/state or country were eligible. Twenty eligible studies were included, reporting HCV care cascade in 28 populations/sub-populations from 11 countries. DAA treatment uptake at national levels was reported from Iceland (95%), Egypt (92%), Georgia (79%), Norway (18%) and Sweden (8%), and at sub-national levels from the Netherlands (52%), Canada (50%), the United States (29%) and Denmark (5%). Among people with HIV-HCV co-infection, DAA treatment uptake was 62% in Canada, 44% in the Netherlands, 21% in Switzerland and 18% in the United States. Among people who inject drugs, DAA treatment uptake was 50% in Georgia, 40% in Canada, 37% in Australia and 13% in the United States. Data among people experiencing homelessness were only available from the United States (treatment uptake: 12%-14%). We found no eligible study reporting HCV care cascade data in prisons. Relatively few countries reported HCV care cascade at the national level. DAA treatment uptake was widely varied across populations/sub-populations, with higher rates reported in recent years.

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Time to HCV Treatment Disfavors Patients Living with HIV/HCV Co-infection: Findings from a Large Urban Tertiary Center

Sims

Truong

Wang

et al. 2021

J. Racial and Ethnic Health Disparities

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Cascade of Care for Alaska Native People With Chronic Hepatitis C Virus Infection: Statewide Program With High Linkage to Care

Cited by 11 publications

References 11 publications

Psychosocial Obstacles to Hepatitis C Treatment Initiation Among Patients in Care: A Hitch in the Cascade of Cure

Psychosocial Obstacles to Hepatitis C Treatment Initiation Among Patients in Care: A Hitch in the Cascade of Cure

Global cascade of care for chronic hepatitis C virus infection: A systematic review and meta‐analysis

Time to HCV Treatment Disfavors Patients Living with HIV/HCV Co-infection: Findings from a Large Urban Tertiary Center

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