A Comprehensive Hepatitis C Treatment Program—An Observational Study of Collaboration Between Infectious Disease Specialists and General Internal Medicine Provider Serving a Majority Black Population

Abstract

Background Hepatitis C (HCV) is a global health problem with a significant economic burden. The aim of this study was to explore the efficacy of oral direct acting antiviral HCV treatment in patients managed by infectious disease (ID) specialists and general internal medicine (GM) provider. Methods This is a retrospective cohort study on patients with HCV seen at the ID clinics at an academic medical center (January 2015–March 2021). Patients were managed either exclusively by ID specialists, comanaged by ID and GM practitioner (ID/GM), or independently managed by GM provider. Results A total of 532 patients (median age, 65 years (interquartile range, 58–68 years), 67.3% males, 87.2% Blacks) were seen for HCV treatment. There were 170 HIV-HCV coinfected patients and 362 HCV monoinfected patients. Almost 60% of the patients (n = 318) were seen by ID, 18.6% (n = 99) were comanaged by ID/GM, and 21.6% (n = 115) were seen by GM. Sustained virologic responses at 12 weeks after treatment completion were similar among the patients seen by different providers, 95.9% in ID versus 96.9% in ID/GM versus 100% in GM group (P = 0.33). In the multivariable regression model, sustained virologic response at 12 weeks had no significant association with the type of provider who treated the patients for HCV treatment (P = 0.78). Conclusions These findings support the high efficacy of HCV treatment, irrespective of whether the treatment was administered by ID or GM providers. More primary care providers trained in treating HCV can assist in the expansion of treatment initiatives aimed toward HCV elimination.