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2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina

BACKGROUND: Approximately 3.9 million Americans live with chronic Hepatitis C virus (CHCV). Major advances have been made in the treatment of CHCV, with the availability of oral directly acting antiviral (DAA) regimens. However, significant barriers to treatment remain for patients accessing safety...

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Autores principales: Olatosi, Akinwale, Motiani, Rishika, Adebajo, Adelero, Bharadwaj, Ramesh, Arroyo, Julio, Stewart, Ada, Olatosi, Bankole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253044/
http://dx.doi.org/10.1093/ofid/ofy210.1883
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author Olatosi, Akinwale
Motiani, Rishika
Adebajo, Adelero
Bharadwaj, Ramesh
Arroyo, Julio
Stewart, Ada
Olatosi, Bankole
author_facet Olatosi, Akinwale
Motiani, Rishika
Adebajo, Adelero
Bharadwaj, Ramesh
Arroyo, Julio
Stewart, Ada
Olatosi, Bankole
author_sort Olatosi, Akinwale
collection PubMed
description BACKGROUND: Approximately 3.9 million Americans live with chronic Hepatitis C virus (CHCV). Major advances have been made in the treatment of CHCV, with the availability of oral directly acting antiviral (DAA) regimens. However, significant barriers to treatment remain for patients accessing safety net providers for care. In 2011, 61,294 Community Health Center (CHC) patients had Hepatitis C as their primary diagnosis. This study provides insight into unique CHC patient characteristics and outcomes of care at two federally qualified health centers (FQHC). METHODS: We queried electronic health records (EHR) from Q4 2014 to Q1 2018 for Hep C patients attending two FQHCs in South Carolina (n = 223). Data from both practices were aggregated to capture sustained virologic (SVR) rates at 12 weeks post treatment. Patient demographic factors, including age; gender; race/ethnicity, insurance status and people who inject drugs (PWID) were extracted. Clinical measures such as baseline and post treatment viral loads, Fibrosure, AST to Platelet Ratio Index (APRI) measures, pre treatment and post treatment liver ultrasound screening, HCV genotype, and HIV co-infection are reported. Patient outcomes were monitored using SVR viral load values (detectable or nondetectable) at 12 weeks and 1 year from treatment onset. RESULTS: Mean age was 57.03 SD ± 0.65 with 71.7% of the population treated aged 55 or older. Most patients were males (63.2%), African American (68.2%) and uninsured (31.4%). Median baseline HCV viral load was 1,950,000 IU/mL. About 95.9% of the patients were naïve to Hepatitis C treatment. Majority of Fibrosure stages (F0–F2 48.9%; and F3–F4 37.2%) and APRI scores both showed about half of patients presented with little likelihood of liver cirrhosis. Post-liver ultrasound occurred in 37.7% of the population. Top three genotypes were 1a (67.3%), 1b (17.5%) and 2b (5.8%). The proportion of PWID among those responding was 23.4%.HIV coinfection in the population sample was 29.1%, while the SVR VL was nondetectable for 97.6%. CONCLUSION: Overall, FQHCs served the CDC target baby boomer population age group. Findings show Hepatitis C treatment can be successfully undertaken at FQHCs including difficult to treat populations such as PWID. The SVR viral load shows efficacy of treatment at both FQHCs. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62530442018-11-28 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina Olatosi, Akinwale Motiani, Rishika Adebajo, Adelero Bharadwaj, Ramesh Arroyo, Julio Stewart, Ada Olatosi, Bankole Open Forum Infect Dis Abstracts BACKGROUND: Approximately 3.9 million Americans live with chronic Hepatitis C virus (CHCV). Major advances have been made in the treatment of CHCV, with the availability of oral directly acting antiviral (DAA) regimens. However, significant barriers to treatment remain for patients accessing safety net providers for care. In 2011, 61,294 Community Health Center (CHC) patients had Hepatitis C as their primary diagnosis. This study provides insight into unique CHC patient characteristics and outcomes of care at two federally qualified health centers (FQHC). METHODS: We queried electronic health records (EHR) from Q4 2014 to Q1 2018 for Hep C patients attending two FQHCs in South Carolina (n = 223). Data from both practices were aggregated to capture sustained virologic (SVR) rates at 12 weeks post treatment. Patient demographic factors, including age; gender; race/ethnicity, insurance status and people who inject drugs (PWID) were extracted. Clinical measures such as baseline and post treatment viral loads, Fibrosure, AST to Platelet Ratio Index (APRI) measures, pre treatment and post treatment liver ultrasound screening, HCV genotype, and HIV co-infection are reported. Patient outcomes were monitored using SVR viral load values (detectable or nondetectable) at 12 weeks and 1 year from treatment onset. RESULTS: Mean age was 57.03 SD ± 0.65 with 71.7% of the population treated aged 55 or older. Most patients were males (63.2%), African American (68.2%) and uninsured (31.4%). Median baseline HCV viral load was 1,950,000 IU/mL. About 95.9% of the patients were naïve to Hepatitis C treatment. Majority of Fibrosure stages (F0–F2 48.9%; and F3–F4 37.2%) and APRI scores both showed about half of patients presented with little likelihood of liver cirrhosis. Post-liver ultrasound occurred in 37.7% of the population. Top three genotypes were 1a (67.3%), 1b (17.5%) and 2b (5.8%). The proportion of PWID among those responding was 23.4%.HIV coinfection in the population sample was 29.1%, while the SVR VL was nondetectable for 97.6%. CONCLUSION: Overall, FQHCs served the CDC target baby boomer population age group. Findings show Hepatitis C treatment can be successfully undertaken at FQHCs including difficult to treat populations such as PWID. The SVR viral load shows efficacy of treatment at both FQHCs. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253044/ http://dx.doi.org/10.1093/ofid/ofy210.1883 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Olatosi, Akinwale
Motiani, Rishika
Adebajo, Adelero
Bharadwaj, Ramesh
Arroyo, Julio
Stewart, Ada
Olatosi, Bankole
2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title_full 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title_fullStr 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title_full_unstemmed 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title_short 2230. Treatment Outcomes for Hepatitis C Patients from Two Federally Qualified Community Health Centers in South Carolina
title_sort 2230. treatment outcomes for hepatitis c patients from two federally qualified community health centers in south carolina
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253044/
http://dx.doi.org/10.1093/ofid/ofy210.1883
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