Barriers to hepatitis C treatment in the era of direct‐acting anti‐viral agents

• DOI: 10.1111/apt.14328
• Publication Date: 2017-09-26T07:32:44Z
• Authors: M. Lin; J. Kramer; D. White; Y. Cao; S. Tavakoli‐Tabasi; S. Madu; D. Smith; S. M. Asch; H. B. El‐Serag; F. Kanwal
• Keywords: Hepatitis C; Veterans Affairs; Alcohol abuse; Sofosbuvir

Direct-acting anti-virals (DAA) are safe, effective treatment of hepatitis C virus (HCV). Suboptimal linkage to specialists and access DAAs the leading barriers treatment; however, data limited.To determine predictors follow-up, receipt DAAs, reasons for lack thereof.We used clinical from retrospective cohort HCV-infected patients with previously established HCV care in US Department Veterans Affairs examine follow-up clinics DAA (during 12/1/2013-4/30/2015). We then conducted a structured review medical charts treatment.We identified 84 221 veterans who were seen during pre-DAA era. Of these, 47 165 (56.0%) followed-up specialty clinics, 13 532 (28.7%) whom received DAAs. Older age, prior treatment, presence cirrhosis or HCC, HIV/HBV co-infection psychiatric illness follow-up. Alcohol/drug abuse co-morbidity treatment. 905 prospectively recruited patients, 56.2% had specialist visit 28% Common relocation (n = 148, 37.4%) missed/cancelled appointments 63, 15.9%). Reasons included waiting newer therapy 99, 38.8%), co-morbidities 66, 25.9%) alcohol/drug 24.7%).Half era only 29% Targeted efforts focusing on patient system-levels may improve reach new