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Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans
INTRODUCTION AND AIM. Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058131/ https://www.ncbi.nlm.nih.gov/pubmed/29735789 http://dx.doi.org/10.5604/01.3001.0011.7385 |
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author | Beck, Kendall R. Kim, Nicole J. Khalili, Mandana |
author_facet | Beck, Kendall R. Kim, Nicole J. Khalili, Mandana |
author_sort | Beck, Kendall R. |
collection | PubMed |
description | INTRODUCTION AND AIM. Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA. MATERIAL AND METHODS. Clinical records of AAs undergoing HCV evaluation attending a safety net health system liver clinic were reviewed from 2006 to 2011 (pre-DAA), and January 1, 2014 to December 31, 2016 (post-DAA). RESULTS. 291 patients were identified (129 pre-DAA, and 162 post-DAA). Median age was 58, 66% were male, 91% had HCV genotype 1, and 70% had fibrosis ≥ stage 2. Post-DAA patients were older (60 vs. 53 years; p < 0.001), had higher rates of insurance (98% vs. 88%; p < 0.001), liver fibrosis ≥ stage 2 (77% vs. 61%; p = 0.048), ≥ 2 medical comorbidities (19 vs. 0.8%; p < 0.001), and median baseline log10 HCV RNA (6.07 vs. 5.81 IU/mL; p < 0.001), but lower median ALT (46 vs. 62 U/L; p < 0.001). Post-DAA, fewer patients were treatment ineligible (5.6% vs. 39%; p < 0.001) and more initiated therapy (71% vs. 8.5%; < 0.001), were adherent to HCV care (82% vs. 38%; p < 0.001), and achieved cure (95.7% vs. 63.6%, p < 0.001). Availability of DAA was independently associated with improved adherence to HCV care (OR 10.3, 95% CI 4.84–22.0). CONCLUSION. Availability of DAA is associated with increased treatment eligibility, initiation, adherence to HCV care, and cure in HCV-infected underserved AAs; highlighting the critical role of access to DAA in this population. |
format | Online Article Text |
id | pubmed-7058131 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
record_format | MEDLINE/PubMed |
spelling | pubmed-70581312020-03-05 Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans Beck, Kendall R. Kim, Nicole J. Khalili, Mandana Ann Hepatol Article INTRODUCTION AND AIM. Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA. MATERIAL AND METHODS. Clinical records of AAs undergoing HCV evaluation attending a safety net health system liver clinic were reviewed from 2006 to 2011 (pre-DAA), and January 1, 2014 to December 31, 2016 (post-DAA). RESULTS. 291 patients were identified (129 pre-DAA, and 162 post-DAA). Median age was 58, 66% were male, 91% had HCV genotype 1, and 70% had fibrosis ≥ stage 2. Post-DAA patients were older (60 vs. 53 years; p < 0.001), had higher rates of insurance (98% vs. 88%; p < 0.001), liver fibrosis ≥ stage 2 (77% vs. 61%; p = 0.048), ≥ 2 medical comorbidities (19 vs. 0.8%; p < 0.001), and median baseline log10 HCV RNA (6.07 vs. 5.81 IU/mL; p < 0.001), but lower median ALT (46 vs. 62 U/L; p < 0.001). Post-DAA, fewer patients were treatment ineligible (5.6% vs. 39%; p < 0.001) and more initiated therapy (71% vs. 8.5%; < 0.001), were adherent to HCV care (82% vs. 38%; p < 0.001), and achieved cure (95.7% vs. 63.6%, p < 0.001). Availability of DAA was independently associated with improved adherence to HCV care (OR 10.3, 95% CI 4.84–22.0). CONCLUSION. Availability of DAA is associated with increased treatment eligibility, initiation, adherence to HCV care, and cure in HCV-infected underserved AAs; highlighting the critical role of access to DAA in this population. 2018-04-09 2018 /pmc/articles/PMC7058131/ /pubmed/29735789 http://dx.doi.org/10.5604/01.3001.0011.7385 Text en This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Beck, Kendall R. Kim, Nicole J. Khalili, Mandana Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title | Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title_full | Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title_fullStr | Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title_full_unstemmed | Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title_short | Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans |
title_sort | direct acting antivirals improve hcv treatment initiation and adherence among underserved african americans |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058131/ https://www.ncbi.nlm.nih.gov/pubmed/29735789 http://dx.doi.org/10.5604/01.3001.0011.7385 |
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