Related Experiment Video
Updated: Oct 3, 2025
Humanized NOD/SCID/IL2rγnull (hu-NSG) Mouse Model for HIV Replication and Latency Studies
Published on: January 7, 2019
Hepatitis C virus micro-elimination within a clinic for people with HIV: challenges in the home stretch
Jaklin Hanna1, Jihan Sufian1, Jin S Suh1,2
1St. Joseph's University Medical Center, Paterson, New Jersey, USA.
Insights
A pharmacist-led campaign significantly reduced chronic hepatitis C virus (HCV) infection in people with HIV. Key barriers to HCV care included drug use and poor engagement, impacting treatment success.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- People with HIV often have co-occurring chronic hepatitis C virus (HCV) infections.
- Addressing HCV in this population is crucial for improving health outcomes and reducing disease transmission.
- Previous treatment initiatives may not have reached all eligible patients, necessitating further intervention.
Purpose of the Study:
- To evaluate a pharmacist-led campaign to decrease chronic HCV infection among individuals with HIV.
- To identify and analyze barriers to HCV care within this specific patient group.
- To assess the effectiveness of direct-acting antiviral (DAA) treatment coordination by pharmacists.
Main Methods:
- Retrospective chart review and electronic reports identified patients with ongoing HCV infection post-intervention.
- Clinical pharmacists offered and coordinated DAA treatment during routine HIV care visits.
- Logistic regression analyzed predictors of sustained virologic response (SVR).
Main Results:
- HCV prevalence decreased from an initial percentage to 0.6% post-intervention (p < 0.0001).
- Among eligible patients, 70% accepted DAA therapy, 63% initiated it, and 50% achieved SVR.
- Major barriers included recreational drug use (67%), poor engagement in care (61%), and mental health disorders (28%).
Conclusions:
- Pharmacist-led interventions can effectively reduce the burden of HCV in people with HIV.
- Poor engagement in care is a significant barrier to HCV treatment and sustained virologic response.
- Integrating HCV care within the HIV continuum of care is vital for micro-elimination efforts.
Objectives:
To describe a pharmacist-led campaign aimed at reducing the proportion of people with HIV with ongoing chronic hepatitis C virus (HCV) infection and delineating barriers to HCV care in this patient population.
Methods:
An electronic report and retrospective chart review were used to identify patients who remained with HCV infections after a previous treatment initiative. A clinical pharmacist and pharmacy resident approached the remaining HCV patients during their routine visits for HIV care to offer and coordinate direct-acting antiviral (DAA) treatment. The primary end-point was to compare the prevalence of chronic HCV before and after the intervention period. Barriers to care were also evaluated, with logistic regression performed to identify predictors of sustained virologic response (SVR) attainment.
Results:
Forty-six patients were included in the analysis (4.2% of clinic population), with HCV prevalence falling to 0.6% (six patients) by the end of the study (p < 0.0001). The HCV care cascade in the cohort was as follows: 70% agreed to and received DAA therapy, 63% initiated therapy, and 50% achieved SVR. The top barriers to care at baseline included recreational drug use (67%), poor engagement in care (61%), and mental health disorders (28%). Poor engagement in care and active recreational drug use were associated with decreased odds of achieving SVR in bivariate analysis.
Conclusions:
A coordinated effort can make strides towards reducing the overall burden of HCV in this challenging population. The HCV care cascade remains tied to the HIV continuum of care, with poor engagement in care remaining an important rate-limiting step impeding micro-elimination.
