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Abstract Details
Closing the hepatitis C treatment gap: United States strategies to improve retention in care
J Viral Hepat. 2022 May 12. doi: 10.1111/jvh.13685. Online ahead of print.
1Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado, USA.
2Department of Emergency Medicine, University of California Los Angeles Medical Center, Los Angeles, California, USA.
3Section of Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
4Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.
Abstract
The hepatitis C virus (HCV) treatment landscape is shifting given the advent of direct-acting antivirals and a global call to action by the World Health Organization. Eliminating HCV is now an issue of healthcare delivery. Treatment is limited by the complexity of the HCV care continuum, expensive therapy and competing health burdens experienced by an underserved HCV population. The objective of this literature review was to assess strategies to improve retention in HCV care, with particular focus on those implemented in the United States. We identified barriers in HCV care retention and propose solutions to increase HCV treatment delivery. The following recommendations are herein described: improving the cohesion of health services through localized care and integrated case management, expanding the supply of non-specialist HCV treatment providers, leveraging patient navigators and care coordinators, improving adherence through directly observed therapy and reducing cost barriers through value-based payment and pharmaceutical subscription models.