New Treatments Have Changed the Game: Hepatitis C Treatment in Primary Care

Shelley N Facente; Katie Burk; Kelly Eagen; Elise S Mara; Aaron A Smith; Colleen S Lynch

doi:10.1016/j.idc.2018.02.012

New Treatments Have Changed the Game: Hepatitis C Treatment in Primary Care

Infect Dis Clin North Am. 2018 Jun;32(2):313-322. doi: 10.1016/j.idc.2018.02.012.

Authors

Shelley N Facente¹, Katie Burk², Kelly Eagen³, Elise S Mara⁴, Aaron A Smith², Colleen S Lynch⁵

Affiliations

¹ Facente Consulting, 5601 Van Fleet Avenue, Richmond, CA 94804, USA.
² Community Health Equity and Promotion Branch, San Francisco Department of Public Health, 25 Van Ness Suite 500, San Francisco, CA 94102, USA.
³ San Francisco Department of Public Health, Medical Respite and Sobering Center, 101 Grove Street, Room 118, San Francisco, CA 94102, USA; Tom Waddell Integrated Medical Services, San Francisco Health Network, San Francisco Department of Public Health, 101 Grove Street, Room 118, San Francisco, CA 94102, USA; Department of Family and Community Medicine, University of California, San Francisco (UCSF), Zuckerberg, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
⁴ ARCHES Branch, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102, USA.
⁵ Clinical Practice, Southeast Health Center, San Francisco Health Network, San Francisco Department of Public Health, ZSFG Office at Ward 82 Room 246, 2401 Keith Street, San Francisco, CA 94124, USA; University of California, San Francisco (UCSF), Zuckerberg, San Francisco General Hospital, ZSFG Office at Ward 82 Room 246, 995 Potrero Ave San Francisco, CA 94110, USA. Electronic address: colleen.lynch@sfdph.org.

PMID: 29778258
DOI: 10.1016/j.idc.2018.02.012

Abstract

In the pre-direct-acting antiviral era, hepatitis C virus (HCV) treatments were complex and largely managed by hepatologists, gastroenterologists, and infectious disease physicians. As direct-acting antivirals have driven up demand for treatment, the relative scarcity of these specialists has created a bottleneck effect, resulting in only a fraction of HCV-infected individuals offered treatment. The San Francisco Health Network is a safety net system of care. Its intervention was designed to be sustainable and scalable; with minimal time commitments for training providers, primary care-based HCV treatment increased 3-fold in a period of just over 3 years.

Keywords: Clinician training; HCV; Hepatitis C virus; Primary care; Primary care provider; Provider training; Treatment.

Publication types

Review

MeSH terms

Antiviral Agents / administration & dosage
Antiviral Agents / adverse effects
Antiviral Agents / therapeutic use*
Hepacivirus / drug effects
Hepatitis C / drug therapy*
Hepatitis C / epidemiology
Hepatitis C / virology
Hepatitis C, Chronic / drug therapy*
Hepatitis C, Chronic / epidemiology
Hepatitis C, Chronic / virology
Humans
Physicians
Primary Health Care*
San Francisco / epidemiology

Substances

Antiviral Agents