Hepatitis C Treatment Outcomes for Patients With Infective Endocarditis Treated by an Interdisciplinary Team

Area of Science:

• Infectious Diseases
• Hepatology
• Pharmacology

Background:

• Patients with infective endocarditis frequently have comorbid injection substance use, increasing their risk for hepatitis C virus (HCV) infection.
• This population faces significant barriers to accessing and completing HCV treatment.
• An interdisciplinary collaboration was established between specialty pharmacy and an endocarditis team to address these challenges.

Purpose of the Study:

• To evaluate the treatment outcomes of patients with infective endocarditis and HCV infection who received coordinated care.
• To assess the effectiveness of an interdisciplinary approach in improving access to and completion of HCV treatment.

Main Methods:

• A retrospective study was conducted involving patients with infective endocarditis and HCV infection from September 2021 to April 2024.
• Data on patient demographics and treatment outcomes were reviewed.
• An interdisciplinary team coordinated expedited HCV treatment and outpatient follow-up for inpatients.

Main Results:

• 64 patients were identified; 97% had a history of injection drug use.
• 75% initiated HCV treatment upon discharge, with 69% completing therapy.
• Sustained virologic response at 12 weeks was achieved in 42% of those who initiated treatment, and 91% of those with available lab results were HCV RNA negative posttreatment.

Conclusions:

• Despite interdisciplinary coordination, sustained virologic response rates for endocarditis patients with HCV remained below 40%.
• Further research is needed to optimize interventions, such as initiating therapy during inpatient stay or upon discharge.
• Exploring strategies like dispensing the entire medication course at once may improve treatment outcomes.