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. 2022 Dec;29(12):1062-1072.
doi: 10.1111/jvh.13746. Epub 2022 Sep 12.

HCV hotline facilitates Hepatitis C elimination during the COVID-19 pandemic

Lukas Hartl  1   2 , Mathias Jachs  1   2 , David Bauer  1   2 , Benedikt Simbrunner  1   2 , David Chromy  1   2   3 , Teresa Binter  1   2 , Lisa Steininger  1   2 , Caroline Schwarz  2   4 , Michael Schwarz  2   4 , Lukas Burghart  2   4 , Robert Strassl  5 , Michael Trauner  1 , Michael Gschwantler  4 , Mattias Mandorfer  1   2 , Thomas Reiberger  1   2
Affiliations

HCV hotline facilitates Hepatitis C elimination during the COVID-19 pandemic

Lukas Hartl et al. J Viral Hepat. 2022 Dec.

Abstract

The COVID-19 pandemic necessitates healthcare restrictions that also affected ongoing hepatitis C virus (HCV) elimination efforts. We assessed the value of a physician-operated HCV hotline on treatment and cure rates throughout the pandemic. All HCV patients undergoing HCV therapy at the Vienna General Hospital from 2019 to 2021 were included. An HCV hotline was established in 2019 and provided services including phone calls, text messages and voicemails. Patients were stratified by date of HCV therapy: 2019 (pre-COVID) vs. 2020/2021 (during-COVID) and use of the HCV hotline: users vs. non-users. Overall, 220 patients were included (pre-COVID: n = 91 vs. during-COVID: n = 129). The prevalence of intravenous drug use (60.5%) and alcohol abuse (24.8%) was high during COVID. During COVID, the number of DAA treatment starts declined by 24.2% (n = 69) in 2020 and by 34.1% (n = 60) in 2021 vs. pre-COVID (n = 91, 100%). Significantly more patients used the HCV hotline during-COVID (95.3%) vs. pre-COVID (65.9%; p < .001). Sustained virologic response (SVR) was 84.6% pre-COVID and 86.0% during-COVID. HCV hotline users achieved higher SVR rates during-COVID (88.2% vs. 33.3%, p = .004), but also pre-COVID (96.7% vs. 61.3%, p < .001) compared with non-users. Considering only patients with completed DAA treatments, SVR rates remained similarly high during-COVID (96.9%) versus pre-COVID (98.1%). HCV treatment initiations decreased during-COVID but importantly, nearly all DAA-treated HCV patients used the HCV hotline during the COVID pandemic. Overall, the SVR rate remained at 88.2% during COVID and was particularly high in HCV phone users-most likely due to facilitation of adherence.

Keywords: COVID-19; elimination; hepatitis C virus; telemedicine.

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Conflict of interest statement

L.H., M.J., D.C., T.B., L.S., C.S., M.S., L.B. and R.S. have nothing to disclose. D.B. received speaker fees from AbbVie and Siemens, as well as grant support form Gilead and Siemens, as well as travel support from AbbVie and Gilead. B.Sim. received travel support from AbbVie and Gilead. M.T. served as a speaker and/or consultant and/or advisory board member for Albireo, BiomX, Falk, Boehringer Ingelheim, Bristol‐Myers Squibb, Falk, Genfit, Gilead, Intercept, Janssen, MSD, Novartis, Phenex, Pliant, Regulus, and Shire, and received travel support from AbbVie, Falk, Gilead, and Intercept, as well as grants/research support from Albireo, Alnylam, Cymabay, Falk, Gilead, Intercept, MSD, Takeda, and UltraGenyx. He is also co‐inventor of patents on the medical use of 24‐norursodeoxycholic acid. M.G. received grants from AbbVie, Gilead and MSD; speaking honoraria/advisory board fees from AbbVie, Gilead, MSD, Janssen, BMS, Roche, Intercept, Norgine, AstraZeneca, Alnylam, Falk and Shionogi. M.M. served as a speaker and/or consultant and/or advisory board member for AbbVie, Gilead, and W. L. Gore & Associates and received travel support from AbbVie and Gilead. T.R. served as a speaker and/or consultant and/or advisory board member for AbbVie, Bayer, Boehringer Ingelheim, Gilead, Intercept, MSD, Siemens, and W. L. Gore & Associates and received grants/research support from AbbVie, Boehringer Ingelheim, Gilead, Intercept, MSD, Myr Pharmaceuticals, Pliant, Philips, Siemens and W. L. Gore & Associates as well as travel support from AbbVie, Boehringer Ingelheim, Gilead and Roche.

Figures

FIGURE 1
FIGURE 1
Evolution of (A) DAA treatment starts, (B) HCV hotline phone calls, text messages and voicemails over the course of the COVID‐19 pandemic (i.e. 01 January 2020–30 June 2020 [h1/2020], 01 July 2020–31 December 2020 [h2/2020], 01 January 2021–30 June 2021 [h1/2021] and 01 July 2021–31 December 2021 [h2/2021]) relative to the respective time periods before the pandemic (01 January 2019–31 December 2019). (C) Percentage of sustained virologic response (SVR) shown for all HCV patients and for the subgroup of patients managed via the HCV hotline (HCV hotline users) over the course of the COVID‐19 pandemic. Panel (D) shows the comparison of SVR rates between patients using (HCV hotline users) and not using the HCV hotline (HCV hotline non‐users).
FIGURE 2
FIGURE 2
Proportion of patients with different (A) fibrosis stages, (B) transmission routes, (C) HCV genotypes and (D) alcohol abuse undergoing DAA therapy over the course of the COVID‐19 pandemic (i.e. 01 January 2020–30 June 2020 [h1/2020], 01 July 2020–31 December 2020 [h2/2020], 01 January 2021–30 June 2021 [h1/2021] and 01 July 2021–31 December 2021 [h2/2021]). DAA, direct acting antiviral; IVDU, intravenous drug use; HCV, hepatitis C virus; MSM, men who have sex with men.
FIGURE 3
FIGURE 3
Comparison of relative numbers of (A) sustained virologic response (SVR), (B) human immunodeficiency virus (HIV) coinfection, (C) intravenous drug use (IVDU), (D) alcohol abuse and (E) fibrosis stage F2/3/4 among patients undergoing DAA therapy prior to (01 January 2019–31 December 2019) and during (01 January 2020–31 December 2021) the COVID‐19 pandemic.
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