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• W2912057236 abstract "Introduction: CommUnityCare [CUC] Hepatitis C clinic (FQHC) was launched March 2014. CUC serves as a safety net provider to Austin, Texas' high risk uninsured, homeless and refugee population. The clinic offered Hepatitis C [HCV] treatment to patients in whom barriers such as cost, unstable living environments and medical comorbidities had previously limited access to HCV therapy. Treatment regimens included direct acting antivirals (DAA) ledipasvir/sofosbuvir (LDV/SOF) Ombitasvir/Parataprevir/Ritonavir/Dasabuvir (PrOD), Velpatasvir/Sofosbuvir (SOF/VEL), Elbasvir/Grazoprevir (E/G), and Daclatasvir/Sofosbuvir (SOF/DCV) per AASLD recommended guidelines. Methods: Single center retrospective analysis was conducted on HCV patients who received above therapies per AASLD guidelines. HCV RNA levels were measured using a COBAS® Ampliprep/COBAS® TaqMan® HCV Test with a lower limit of detection of 15 IU/L. Sustained viral response [SVR12] was defined as undetectable HCV RNA at 12 weeks post treatment. The primary endpoint was the proportion of patients who had undetectable SVR12. Results: March 2014 - October 2016, 520 patients were treated with the above stated DAAs. Mean age 55 years; 76% males; 85% were uninsured; 72% genotype 1, 97% naive and 8.5% were cirrhotic. We performed intention to treat analysis (ITT) and per protocol analysis (PPA - patients who completed therapy 12 or 24 week and returned for SVR12). 330 returned for SVR12 results. 326 achieved SVR12 (ITT 63%), PPA 99%). LDV/SOF: n = 408, ITT (66%), PPA (99%); PrOD: n = 33, ITT (81%), PPA (100%); SOF/DCV: n = 47, ITT (57%), PPA (100%); E/G: n = 10, ITT (50%), PPA (80%); SOF/VEL: n = 22, ITT (13%) PPA (100%). Per protocol analysis 4 patients relapsed [2 LDV/SOF; 1 E/G; and 1 SOF/VEL]. LDV/SOF patients who relapsed were treatment naïve and non-cirrhotic. The E/G patient who relapsed had G1a, NS5a resistance and compensated cirrhosis. The SOF/VEL patient was G3, treatment naïve and cirrhotic. Conclusion: Our study demonstrates that treatment with DAAs can allow this unique vulnerable population to achieve SVR12 with rates comparable to published study data. Discrepancy between SVR12, ITT and PPA rates are attributed to lack of transportation, relocation of patient and change in patient contact information. By continuing to treat the low socioeconomic population with DAAs at an FQHC, ultimately there will be a significant reduction in the HCV prevalence and eliminating HCV within our community." @default.
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• W2912057236 date "2017-10-01" @default.
• W2912057236 modified "2023-09-27" @default.
• W2912057236 title "DAA Hepatitis C Treatment in Low Socioeconomic Population at a Federally Qualified Health Center (FQHC)" @default.
• W2912057236 doi "https://doi.org/10.14309/00000434-201710001-00889" @default.
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