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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
CALIFORNIA: Formal HCV Education Improved Time to Therapy Initiation, Response
Staff Writer
April 8, 2013
Healio (04.03.13) Aids Weekly Plus

A recent study indicated that individuals with hepatitis C virus (HCV) infection who participated in a class about the disease began therapy more quickly and experienced sustained virologic response (SVR) more often than those who did not participate in the class. Researchers conducted a cross-sectional survey of 94 San Francisco-based primary care providers and performed a retrospective records review of 118 HCV-infected patients before and after a formal HCV education class. A liver clinic nurse practitioner presented the 2-hour class, which focused on HCV symptoms, diagnosis and transmission, candidacy for therapy, and side effects of treatment. Results show that the 60 class participants had a significantly shorter time to treatment initiation than the 58 patients who did not participate in the class (median 136 days versus 284 days). More class participants had SVR to treatment (68 percent versus 50 percent), had lower discontinuation rates from side effects (3 percent versus 12 percent), and had fewer relapses (16 percent versus 28 percent) than those who did not attend the class. Multivariate analysis indicated that participation and HCV genotype were significantly associated with SVR. There was a significant negative association between HCV education and the time to therapy initiation after adjusting for age, sex, race, HCV genotype, and liver disease severity. None of the differences was statistically significant. Data indicate that 90 percent of responding providers knew of the program and 40 percent referred approximately half of their patients to it. Seventy percent of respondents believed the class increased their knowledge of the disease, interest in treatment, and patient-physician communication. The researchers concluded that formal HCV education by liver specialists creates efficiencies in resource-limited healthcare systems, which allows for better access to specialty care and treatment services, and improves effectiveness of HCV antivirals. Also, interventions that increase provider knowledge of the disease and the importance of patient education in improving disease management will enhance HCV care coordination and improve the success of therapy, especially in vulnerable populations. The full report, "Formal Hepatitis C Education Enhances HCV Care Coordination, Expedites HCV Treatment and Improves Antiviral Response,” is published online in the journal Liver International (2013; doi: 10.1111/liv.12150).