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2153. Hepatitis C (HCV) Treatment Experience With Direct-Acting
Antivirals (DAAs) in a Large Urban Clinic
Sonia Vibhakar, PharmD1; Oluwatoyin Adeyemi, MD2; Rebecca Goldberg, RN3;
Kerianne Burke, MPH1; Maureen Gallagher, NP4; Deborah Wolen, NP5; Benjamin Go,
MD6; Gregory Huhn, MD, MPHTM7;
1
Ruth M. Rothstein CORE Center, Cook County
Health and Hospitals System, Chicago, Illinois;
2
Ruth M. Rothstein CORE Center,
Cook County Health and Hospitals System and Rush University Medical Center,
Chicago, Illinois;
3
CORE Center, Chicago, Illinois;
4
Ruth M. Rothstein CORE Center,
Chicago, Chicago, Illinois;
5
CORE Center, Chicago, Illinois;
6
Cook County Health and
Hospitals System, Chicago, Illinois;
7
Infectious Diseases, Ruth M. Rothstein CORE
Center, Chicago, Illinois
Session: 237. HIV/HCV Coinfection and Liver Disease
Saturday, October 29, 2016: 12:30 PM
Background.DAAs have revolutionized the treatment of HCV, with cure rates of
95%–100%, lower pill burden, and minimal adverse effects. The Ruth M. Rothstein
CORE Center hepatitis clinic provides specialty HCV services to both monoinfected
and HCV/HIV-coinfected patients. Per clinic protocol, patients referred for treatment
must have a checklist completed by the provider and consultation with the pharmacist
to review benefits, laboratory tests, and drug interactions. Patients are followed month-
ly, and all medications are dispensed to patients at their monthly follow-up for the
duration of treatment. We assessed treatment outcomes among patients undergoing
Fibroscan referred for DAA treatment.
Methods.We retrospectively reviewed our clinic database of all patients referred
and treat ed for HCV with newly approved DAAs from Febr uary 20 14 through
March 2016. We analyzed results for patients on treatment for at least 4 weeks.
Results.A total of 258 HCV treatment referrals were made; 48 denied/ineligible
for treatment, 4 referred to study, 2 never started treatment, and 31 patients recently
started/waiting to start treatment were not included. Of the 173 patients included in
the analysis, 118 were male, 62.4% black, 17.9% Hispanic, and 17.3% white. Mean age
was 57 years (range 22–78 years), and 101 patients (58%) were coinfected with HIV.
Median Fibroscan score of 12.1 (range 4.3–75) and 54% were cirrhotic. Forty-three
percent of the patients had Medicaid and 36% Medicare. Sustained virologic response
at 12 weeks (SVR12) data were available on 118 patients. A majority of patients were
treated with Harvoni® (n = 129); 78/80 patients had SVR12 (97.5%); HIV+ 98 % and
HIV- 96.7%. Another 17 patients had end of treatment (EOT) response, and 22 pa-
tients were not detected (ND) or <12 at week 4 and are awaiting an SVR12 visit.
For patients treated with Sof/Riba, 15/19 (79%) had SVR12; 2 had EOT response,
and 2 were ND at week 4. The 4 patients who relapsed were coinfected: 2 patients
were treated with Viekira Pak; 1 relapsed and 1 had EOTresponse. Of 8 patients treated
with Sim/Sof, 7 had SVR12 (87.5%), and 7/10 patients treated with Peg/Sof/Riba had
SVR12 and 1 had EOT response. The 3 patients who relapsed were monoinfected.
Conclusion.In our clinic cohort of predominantly minority patients, the majority
of whom were coinfected with HIV, >90% of patients reaching SVR12 end point have
achieved HCV cure despite the high prevalence of cirrhosis. A multidisciplinary team
approach to monitor patient adherence may be a key contributor in achieving HCV
cure.
Disclosures. All authors: No reported disclosures.
Poster Abstracts •OFID 2016:3 (Suppl 1) •S599