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957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment

BACKGROUND: Published treatment cascades for HIV/HCV co-infection show WHO goals for HCV micro-elimination are not being met. Barriers include entry to care, access to DAA, treatment adherence, and out of care (OOC) patients. A Data to Care approach used to define persons with HIV (PWH) who are OOC,...

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Autores principales: Wegener, Maximilian D, Brooks, Ralph P, Speers, Suzanne, Gosselin, Deborah, Villanueva, Merceditas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777068/
http://dx.doi.org/10.1093/ofid/ofaa439.1143
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author Wegener, Maximilian D
Brooks, Ralph P
Speers, Suzanne
Gosselin, Deborah
Villanueva, Merceditas
author_facet Wegener, Maximilian D
Brooks, Ralph P
Speers, Suzanne
Gosselin, Deborah
Villanueva, Merceditas
author_sort Wegener, Maximilian D
collection PubMed
description BACKGROUND: Published treatment cascades for HIV/HCV co-infection show WHO goals for HCV micro-elimination are not being met. Barriers include entry to care, access to DAA, treatment adherence, and out of care (OOC) patients. A Data to Care approach used to define persons with HIV (PWH) who are OOC, together with DPH-employed DIS to promote re-engagement has been successful for re-engaging OOC PWH. We modified this approach to re-engage OOC HIV/HCV coinfected persons. METHODS: Surveillance databases used: CTEDSS (CT Electronic Disease Surveillance System used for HCV) and eHARS (electronic HIV/AIDS Reporting System). Two OOC cohorts studied: HIV OOC for 12 months (no HIV lab 10/2018-10/2019) and 18 months (no HIV lab 12/2017-6/2019). Lists generated for the 2 cohorts matched to CTEDSS to determine the coinfected OOC. DIS supervisor performed pre-work/case conferencing on lists to assess DIS intervention eligibility. DIS success was defined as those who reengaged (made/kept appointment) out of those successfully contacted. Analysis: tests of homogeneity performed between those OOC and not OOC; evaluation of cases at each level of the intervention; measures of dispersion/central tendency performed illustrating reengagement workload. Project Flow Chart [Image: see text] RESULTS: 12-month OOC: Non-baby boomers (p-value 0.05) and those with detectable HIV VLs (0.04) were more likely to be OOC; 53.7% were DIS-eligible; DIS initiation to client contact, 7 days average (range 4-11); 75 calls and 31 field visits for those successfully contacted; reengagement success rate, 39%. 18-month OOC: Non-baby boomers (0.017), Hispanic and Black race/ethnicity (0.043), and those with detectable HIV viral loads (0.002) were more likely to be OOC; 44% were DIS-eligible; DIS initiation to client contact, 12 days average (range 8-18); 74 calls and 36 field visits for those successfully contacted; reengagement success rate, 43%. Results for the Two Cohorts [Image: see text] Out of Care and Workload Results [Image: see text] CONCLUSION: A data-to-care approach successfully identified, characterized, connected OOC HIV/HCV coinfected patients. DIS provided patient education, facilitating reengagement to care. DIS Success rates are encouraging but small; efforts were labor intensive. Additional strategies focused on preventing non-baby boomers, persons of color, and those with detectable HIV VLs from becoming OOC should be studied. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77770682021-01-07 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment Wegener, Maximilian D Brooks, Ralph P Speers, Suzanne Gosselin, Deborah Villanueva, Merceditas Open Forum Infect Dis Poster Abstracts BACKGROUND: Published treatment cascades for HIV/HCV co-infection show WHO goals for HCV micro-elimination are not being met. Barriers include entry to care, access to DAA, treatment adherence, and out of care (OOC) patients. A Data to Care approach used to define persons with HIV (PWH) who are OOC, together with DPH-employed DIS to promote re-engagement has been successful for re-engaging OOC PWH. We modified this approach to re-engage OOC HIV/HCV coinfected persons. METHODS: Surveillance databases used: CTEDSS (CT Electronic Disease Surveillance System used for HCV) and eHARS (electronic HIV/AIDS Reporting System). Two OOC cohorts studied: HIV OOC for 12 months (no HIV lab 10/2018-10/2019) and 18 months (no HIV lab 12/2017-6/2019). Lists generated for the 2 cohorts matched to CTEDSS to determine the coinfected OOC. DIS supervisor performed pre-work/case conferencing on lists to assess DIS intervention eligibility. DIS success was defined as those who reengaged (made/kept appointment) out of those successfully contacted. Analysis: tests of homogeneity performed between those OOC and not OOC; evaluation of cases at each level of the intervention; measures of dispersion/central tendency performed illustrating reengagement workload. Project Flow Chart [Image: see text] RESULTS: 12-month OOC: Non-baby boomers (p-value 0.05) and those with detectable HIV VLs (0.04) were more likely to be OOC; 53.7% were DIS-eligible; DIS initiation to client contact, 7 days average (range 4-11); 75 calls and 31 field visits for those successfully contacted; reengagement success rate, 39%. 18-month OOC: Non-baby boomers (0.017), Hispanic and Black race/ethnicity (0.043), and those with detectable HIV viral loads (0.002) were more likely to be OOC; 44% were DIS-eligible; DIS initiation to client contact, 12 days average (range 8-18); 74 calls and 36 field visits for those successfully contacted; reengagement success rate, 43%. Results for the Two Cohorts [Image: see text] Out of Care and Workload Results [Image: see text] CONCLUSION: A data-to-care approach successfully identified, characterized, connected OOC HIV/HCV coinfected patients. DIS provided patient education, facilitating reengagement to care. DIS Success rates are encouraging but small; efforts were labor intensive. Additional strategies focused on preventing non-baby boomers, persons of color, and those with detectable HIV VLs from becoming OOC should be studied. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777068/ http://dx.doi.org/10.1093/ofid/ofaa439.1143 Text en © The Author 2020. 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 Poster Abstracts
Wegener, Maximilian D
Brooks, Ralph P
Speers, Suzanne
Gosselin, Deborah
Villanueva, Merceditas
957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title_full 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title_fullStr 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title_full_unstemmed 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title_short 957. Efficacy of Using Disease Intervention Specialists (DIS) to Re-engage Out of Care HIV/HCV Co-Infected Persons into HCV Treatment
title_sort 957. efficacy of using disease intervention specialists (dis) to re-engage out of care hiv/hcv co-infected persons into hcv treatment
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777068/
http://dx.doi.org/10.1093/ofid/ofaa439.1143
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