Providing Hepatitis C Treatment Locally for Substance-Using Patients

This quality improvement (QI) project provided Hepatitis C virus (HCV) treatment at a Federally Qualified Health Clinic (FQHC) for persons who use illicit drugs. Many of these individuals sought treatment at the local Infectious Disease (ID) clinic but were denied care as they require a patient be drug-free for 6 months prior to HCV treatment. These individuals expressed a desire to be cured of HCV, which can lead to liver failure or cirrhosis if left untreated. This project bridged the existing gap in HCV treatment that currently exists for substance-users in this city. Pre-treatment HCV levels were obtained from 20 participants who completed an 8-week daily regimen of Mavyret, a direct-acting antiviral (DAA) agent, prescribed by a primary care Nurse Practitioner (NP), trained to treat HCV. Pre-treatment HCV loads were compared to the sustained viral load, obtained 12 weeks post-treatment (SVR-12), which is considered the "test of cure." The results indicate that 100% of returning patients were considered cured of HCV. This program successfully integrated HCV treatment at a community health center, in a population affected by substance use. Adoption of similar programs in primary care clinics can help meet the clinical needs of this often stigmatized and vulnerable population as well as cure them of HCV.