Inpatient Hepatitis C Treatment Coordination and Initiation for Patients Who Inject Drugs

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Rising hepatitis C (HCV) incidence among people who inject drugs (PWID) necessitates effective treatment strategies.
• Hospitalized PWID with HCV are a priority population for direct-acting antivirals (DAAs) but face significant care linkage barriers.
• Existing screening at our institution did not translate to effective HCV care linkage for hospitalized PWID.

Purpose of the Study:

• To enhance retention in HCV care among hospitalized PWID.
• To evaluate the feasibility and effectiveness of an e-consultation-prompted care coordination and telehealth treatment model for HCV in hospitalized PWID.

Main Methods:

• A quaternary academic center in the Southeast US implemented a program from August 2021 to August 2022.
• Hospitalized PWID diagnosed with HCV were enrolled.
• The intervention involved e-consultation for care coordination and outpatient telehealth for HCV treatment with direct-acting antivirals (DAAs).

Main Results:

• Out of 28 patients, 82% were linked to HCV care, and 52% completed treatment.
• Inpatient DAA initiators achieved a 73% success rate (DAA completion or sustained virologic response).
• Non-inpatient initiators had a 36% success rate, highlighting the benefit of inpatient initiation.

Conclusions:

• Inpatient HCV treatment coordination and DAA initiation, coupled with telehealth follow-up, is a feasible and effective strategy for hospitalized PWID.
• The model demonstrated high rates of linkage to care and treatment completion.
• Future efforts should focus on overcoming barriers to inpatient DAA treatment and expanding this successful model to similar populations.