Increased access and uptake of DAAs in primary care setting is essential to eliminating hepatitis C
Hepatitis researchers have called for better access to direct acting antivirals (DAAs) in primary care, in an effort to eliminate hepatitis C in priority populations.
In a study of hepatitis C treatment among people who inject drugs (PWID), Burnet Institute Infectious Diseases Physician Dr Amanda Wade and her colleagues found significantly better treatment uptake and cure rates among those in primary care settings, compared to hospital-based specialist care.
“In 2016, WHO (the World Health Organization) set hepatitis C elimination targets for 2030: 80 per cent reduction in new cases and 65 per cent reduction in mortality. For this to be achieved, it is essential that there is increased access and uptake of DAAs,” Dr Wade said.
The study of 136 PWID with HCV in Australia and New Zealand, published in Clinical Infectious Diseases, compared two randomly assigned groups who either received DAAs at their primary care site or at a local hospital.
Dr Wade said poor availability of DAAs in primary care limits access to HCV treatment worldwide.
“Moreover, people with hepatitis C commonly report experiencing stigma and discrimination in health care settings, which creates an additional barrier to treatment,”she said.
Dr Wade and her colleagues found a higher sustained viral response after 12 weeks of those treated in primary care – of 49 per cent – against 30 per cent among those treated in hospital.
Additionally, they reported that the intention-to-treat analysis showed that the proportion of participants who started treatment in primary care of (75 per cent) was significantly higher than that in local hospitals (34 per cent).
“Broadening access to DAAs beyond hospital-based services must occur if their benefits are to be fully realised,” Dr Wade said.
Dr Wade said elimination of hepatitis C would only be possible if the global healthcare community engaged people who are difficult to reach.
Find out more about Burnet’s work to eliminate hepatitis C