Virtual Elimination of Hepatitis C Virus from an inner city General Practice

Abstract

To understand treatment outcomes in the modern management of Hepatitis C (HCV) with direct acting antivirals (DAA) at Holdsworth House Medical Brisbane (HHMB), an audit was performed of all HCV diagnoses. A search of all current and past HCV diagnoses on Medtech, the practice software, was done. Active patient records were identified for the audit. All treatments used and outcomes were noted and recorded.

Full text

Virtual Elimination of Hepatitis C Virus
from an inner city General Practice
Dr Kenneth Koh (dr.kenkoh@gmail.com), Holdsworth House Medical Brisbane
90 cases identified
1 liver transplant, 1 not a
regular patient, 1 had
moved interstate, 1
deceased
= 86 active patients
14 h a d spont aneou sly
cleared HCV (16.3%)
= 72 chronic HCV
(cHCV)
21 had r eceive d
interferon in the past
18 successful trea tments
= 54 cHCV remaining
20 out of 20 achieved
SVR 12
= 34 cHCV remaining
27 out of 29 achieved
SVR (93.1%)
To understand treatment outcomes in the
modern management of Hepatitis C
(HCV) with direct acting antivirals (DAA)
at Holdsworth House Medical Brisbane
(HHMB), an audit was performed of all
HCV diagnoses.
A search of all current and past HCV
diagnoses on Medtech, the practice
software, was done. Active patient records
were identified for the audit. All
treatments used and outcomes were noted
and recorded.
1 waiting for SVR
1 treatment failure
3 lost to follow up
1 deferred due to drug-
drug interaction
1 not started treatment
Cases identified Spontaneous Clearance Interferon Treatment
Background Method
Specialist-initiated DAA GP-initiated DAA Final outcome
90 86
72
67
(93%) 65
(97%)
Total HCV Ac ti v e cHCV Treated Cured
HHMB Treatment Cascade
(cHCV)
Age
23 –66
mean 51.8
29 cases treated with GP-initiated
direct acting antivirals
27 Achieved SVR (93.1%)
DAA treatment experience in General Practice, initiated by GP
Direct Acting Antivirals used
•20 Sofosbuvir / Ledipasvir
•4 Sofosbuvir / Daclatasvir
•3 Sofosbuvir / Velpatasvir
•2 Elbasvir / Grazoprevir
Fibrosis
staging
Total
Only
Modality
+ Fibroscan
/ + APRI
APRI 13 85 (old)
Fibroscan
13 4 9
Gender 18 Male 11 Female
Genotype 1 3 4
Number 23 5 1
•4 cirrhosis (Child-Pugh A, Child-Pugh
B, Fibroscan x 2 (13.6 kPa, 11.2 kPa)
-all achieved SVR
•8 HCV/HIV Coinfection
-all achieved SVR
•3 neither APRI/Fibroscan –1 Child Pugh A,
1 Child Pugh B, 1 no information found
Thank you to all the contributors and participants of this audit. Australasian Sexual Health / HIV & AIDS Conference Sept 2019.
Age Range 23 –66 mean 51.8