HCV Treatment Success Not Dependent on Type of Provider

Patients with hepatitis C virus achieve treatment success with specialists, primary care physicians, and nurse practitioners.

The introduction of direct-acting antivirals (DAAs) for hepatitis c virus (HCV) has provided many patients with a cure for the condition and revolutionized the treatment landscape.

A new study published by the Annals of Internal Medicine indicates that achieving sustained virologic response (SVR) among patients with HCV is not affected by the type of health care provider a patient receives their care from. For example, patients achieved similar SVR when seeing specialists, primary care physicians (PCPs), and nurse practitioners (NPs).

These results are significant since there are only 20,000 specialists who are tasked with treating more than 2.7 million Americans with HCV, which may not present barriers.

These findings support the goals in the National Viral Hepatitis Action Plan, which calls for increasing the availability of providers who treat HCV, according to the authors. An approach to achieving this goal is distributing HCV management among various health care workers, including non-specialist providers, which may make better use of health care resources; however, the authors note that data on the success of this approach for HCV are lacking.

To address these gaps, the study examined whether non-specialist providers would be able to provide adequate care for patients with HCV to lessen potential delays in care.

Included in the study were 600 patients with HCV at 13 community health centers in Washington, DC. Patients were treated with ledipasvir and sofosbuvir with a goal of SVR. The authors analyzed the efficacy of HCV management and treatment by specialists, PCPs, and NPs who had received previous training.

The authors found that 86% of patients achieved SVR overall. Notably, the proportion of patients achieving SVR was similar for all providers: 89.3% for NPs, 86.9% for PCPs, and 83.8% for specialists, according to the study.

These results suggest that patients with HCV can be managed by non-specialist providers and achieve SVR.

The authors note that the high cure rates were also observed for patients with HIV co-infections, cirrhosis, or who received previous treatment, according to the study.

The authors report that these findings suggest that non-specialist providers can quickly link patients with diagnosis and treatment, which could avoid delay in treatment by requiring a specialist referral, according to the study.

“The most effective way to reduce deaths and improve the health of people living with HCV infection is to expedite the diagnosis, care, treatment, and cure of all individuals living with chronic HCV infection,” said Corinna Dan, RN, MPH, viral hepatitis policy advisor, Office of HIV/AIDS and Infectious Disease Policy. “Expansion of treatment to non-specialist providers can help us do this and is much needed.”