Improving Hepatitis C Direct-acting Antiviral Access and Uptake

A Role for Patient-reported Outcomes and Lived Experience

Stelliana Goutzamanis; Joseph Doyle; Peter Higgs; Margaret Hellard

Disclosures

J Viral Hepat. 2019;26(2):218-223. 

In This Article

Abstract and Introduction

Abstract

Hepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon-free direct-acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for "hard-to-reach" populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population-level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient-reported outcome measures.

Introduction

With approximately 71 million people chronically infected worldwide and 1.75 million new infections in 2015, hepatitis C virus remains a significant public health concern.[1] In developed countries hepatitis C transmission is predominantly driven by the sharing of injecting equipment, placing people who inject drugs (PWID) at the greatest risk of infection.[2,3] It is estimated that approximately half of the PWID population are hepatitis C antibody positive.[4] Fortunately, the advent of highly effective interferon-free direct-acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for "hard-to-reach" populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population-level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient-reported outcome measures.

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