Evaluation of the Performance of Algorithms That Use Serial Hepatitis C RNA Tests to Predict Treatment Initiation and Sustained Virological Response Among Patients Infected With Hepatitis C Virus

Osinubi, Ademola; Harris, Aaron M.; Vellozzi, Claudia; Lom, Jennifer; Miller, Lesley; Millman, Alexander J.

doi:10.1093/aje/kwy270

Cited by 8 publications

(2 citation statements)

References 12 publications

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“…Approaches and limitations of using proxy measures to measure treatment outcomes have been described previously. 15,16 More than 30% of patients seen at HCV-TAC partner sites (1360 of 3932) who started treatment did not have follow-up HCV RNA results 12 weeks after their estimated treatment completion date; as such, the percentage of patients identified as cured was likely underestimated.…”

Section: Limitationsmentioning

confidence: 99%

Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington

et al. 2019

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Introduction: With the goal of eliminating hepatitis C virus (HCV) as a public health problem in Washington State, Public Health–Seattle & King County (PHSKC) designed a Hepatitis C Virus Test and Cure (HCV-TAC) data system to integrate surveillance, clinical, and laboratory data into a comprehensive database. The intent of the system was to promote identification, treatment, and cure of HCV-infected persons (ie, HCV care cascade) using a population health approach. Materials and Methods: The data system automatically integrated case reports received via telephone and fax from health care providers and laboratories, hepatitis test results reported via electronic laboratory reporting, and data on laboratory and clinic visits reported by 6 regional health care systems. PHSKC examined patient-level laboratory test results and established HCV case classification using Council of State and Territorial Epidemiologists criteria, classifying patients as confirmed if they had detectable HCV RNA. Results: The data enabled PHSKC to report the number of patients at various stages along the HCV care cascade. Of 7747 HCV RNA-positive patients seen by a partner site, 5377 (69%) were assessed for severity of liver fibrosis, 3932 (51%) were treated, and 2592 (33%) were cured. Practice Implications: Data supported local public heath surveillance and HCV program activities. The data system could serve as a foundation for monitoring future HCV prevention and control programs.

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Section: Limitationsmentioning

confidence: 99%

Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington

et al. 2019

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“…It is currently one of the leading etiologies for hepatocellular carcinoma (HCC) and decompensated cirrhosis requiring liver transplantation in Western countries[ 2 , 3 ]. The primary goal of treatment is to achieve the cure of the infection or sustained virologic response (SVR), defined as undetectable HCV RNA in the serum 12 or 24 wk after the end of treatment[ 4 , 5 ]. Since the introduction of first-generation direct acting antiviral agents (DAAs), boceprevir and telaprevir, in 2011, there has been a rapidly expanding population of CHC patients achieving SVR[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Metabolic and cardiovascular complications after virological cure in hepatitis C: What awaits beyond

Shengir¹,

Elgara²,

Sebastiani³

2021

WJG

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The association between chronic hepatitis C (CHC) infection and extrahepatic manifestations (EHMs), particularly cardiometabolic diseases, has been extensively examined. However, there has still been insufficient evaluation for these EHMs after virological cure. Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus (HCV) developing EHMs, cardiometabolic ones, as well as the effect of antiviral therapy to resolve these EHMs. Data on these manifestations after achieving sustained virologic response (SVR) are still conflicting. However, current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile, which increases cardiovascular disease (CVD) risk. Additionally, most observations showed that metabolic alterations, such as insulin resistance and diabetes mellitus (DM), undergo some degree of reduction after viral clearance. These changes seem HCV-genotype dependent. Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM. Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results, with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones. In this review, we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR, which may have an impact on healthcare providers’ clinical practice.

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Hepatitis C virus screening at a Veterans Administration Hospital in New York City

Rostata-Pesola

Olender

Leon

et al. 2020

J Am Assoc Nurse Pract

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Background: Asymptomatic hepatitis C virus (HCV) infection has the highest prevalence in “baby boomers” born in 1945 through 1965. New York State mandates that all persons born during this period be screened at least once for hepatitis C. Local problem: Military veteran HCV screening is often missed during primary care visits. Methods: After baseline screening, provider education with and without an HCV education dashboard of information in the Electronic Medical Record system was used to determine if screening proportions could be improved. The Chi-square and Z-test for independent proportions compared after with before education screening. The odds ratio compared after versus before screening odds. Interventions: Two interventions were tested. One was provider education with a 30-minute lecture. The second was the lecture with addition of an HCV education computer dashboard. Results: The Chi-square test and Z-test comparing the month immediately after provider education was significant for increased screening (p < .01) compared with baseline. There was a 2.04-fold (95% confidence interval, 1.31–3.20) greater odds of screening in the month after education. If two or more months went by after education, the effect of education no longer improved screening proportions. Provider education plus the use of HCV education dashboard did not improve screening from baseline to the month immediately after screening (p = .95). Conclusion: Provider education significantly improved HCV screening the month immediately after education, then regressed toward baseline. Adding an HCV education dashboard to education did not improve screening. To maintain elevated screening proportions, provider screening education must be reinforced on a frequent basis for sustained effect.

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Evaluation of the Performance of Algorithms That Use Serial Hepatitis C RNA Tests to Predict Treatment Initiation and Sustained Virological Response Among Patients Infected With Hepatitis C Virus

Cited by 8 publications

References 12 publications

Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington

Design of an Enhanced Public Health Surveillance System for Hepatitis C Virus Elimination in King County, Washington

Metabolic and cardiovascular complications after virological cure in hepatitis C: What awaits beyond

Hepatitis C virus screening at a Veterans Administration Hospital in New York City

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