New Treatments Have Changed the Game: Hepatitis C Treatment in Primary Care

Area of Science:

• Hepatology
• Infectious Diseases
• Primary Care Medicine

Background:

• Hepatitis C virus (HCV) treatment was historically complex, requiring specialist management by hepatologists, gastroenterologists, and infectious disease physicians.
• The advent of direct-acting antivirals increased treatment demand, but a shortage of specialists created a bottleneck, limiting patient access.
• A significant portion of HCV-infected individuals were not offered timely treatment due to these access barriers.

Purpose of the Study:

• To evaluate the effectiveness and scalability of a primary care-based intervention for hepatitis C virus (HCV) treatment.
• To address the bottleneck effect caused by specialist scarcity in HCV management.
• To increase the number of HCV-infected individuals receiving treatment within a safety net system.

Main Methods:

• Implementation of a training program for primary care providers with minimal time commitment.
• Integration of HCV treatment protocols into primary care settings within the San Francisco Health Network.
• Focus on a sustainable and scalable model for expanding HCV treatment access.

Main Results:

• Primary care-based HCV treatment increased by 3-fold over a period of just over 3 years.
• The intervention demonstrated sustainability and scalability within a safety net healthcare system.
• Overcoming the specialist bottleneck allowed a greater fraction of HCV-infected individuals to be offered treatment.

Conclusions:

• Primary care providers can be effectively trained to manage hepatitis C virus (HCV) treatment.
• A primary care-based approach is a scalable and sustainable solution to increase HCV treatment rates.
• Decentralizing HCV care to primary care settings significantly improves patient access and treatment uptake.