Program Schedule

Implementing Hepatitis C Treatment Programs in Comprehensive HIV Clinics: The Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) Hepatitis C Treatment Expansion Initative

Session: Poster Abstract Session: Viral Infections: Treatment and Prevention
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • Wills HRSA HCV POSTER-2.pdf (323.3 kB)
  • Background: Mortality and morbidity from underlying liver disease in HIV/HCV coinfected patients remains high.  Successful linkage to and retention in HCV treatment for HIV/HCV coinfected patients has been historically poor, with correspondingly low HCV treatment success rates.  In an attempt to address both clinical, training, and workforce related issues regarding this problem, The Hepatitis C Treatment Expansion Initiative was funded by the Health Resources and Services Administration - Special Projects of National Significance branch from 2010-2014.

    Methods: Twenty-nine demonstration site comprehensive HIV clinics were funded for two years to implement  one of four clinic-selected models of HCV care, including: integrated HCV care, designated HCV clinic sessions, HCV care delivery by a primary provider with expert back-up, and referral to an outside specialist for care. An Evaluation and Technical Assistance Center (ETAC) assisted all sites with project implementation,patient-level medical consultation as-needed, monthly didactic and case-based teleconferences, and in-person annual site visits and grantee meetings. Quantitative outcomes measured included number of patients linked to and retained in treatment and the number of treated patients achieving a sustained virologic response (SVR) for each clinic. Qualitative data about model designs were also analyzed.

    Results: 223 patients entered HCV treatment across all clinic sites over the course of the project.  Of those, 195 (87.4%) completed treatment and 99 (44.4%) achieved an SVR.  No statistically significant difference in treatment success was identified based on the model of care delivery selected.  Qualitative analysis of clinic models  through structured interviews and surveys revealed a benefit for clinics that identified a dedicated patient tracker to ensure linkage to and retention in care. Additionally, surveys of demonstration clinic staff including clinical and program personnel revealed increased confidence in initiating care based on the availability of ongoing clinical technical assistance.  

    Conclusion: A dedicated interdisciplinary effort to implement an HCV treatment program within an HIV clinic can improve treatment implementation and completion rates compared to historical rates in similar populations.

    Todd Wills, MD1, Martha Friedrich, PhD1, Jeffrey Beal, MD2, Charurut Somboonwit, MD1, Sean Mcintosh1, Anthony Bork1, Melinda Tinsley, MA3, Adan Cajina, MS3, Pamela Belton3, Jessica Xavier, MPH3, Rupali Doshi, MD, MS4, Renetta Boyd3 and Natalie Solomon, MPH3, (1)Division of Infectious Disease and International Medicine, University of South Florida College of Medicine, Tampa, FL, (2)Mental Health Law & Policy, University of South Florida, Tampa, FL, (3)HRSA Special Projects of National Significance, Rockville, MD, (4)HRSA HIV/AIDS Bureau, Rockville, MD


    T. Wills, Gilead Sciences: Research Contractor, Research grant

    M. Friedrich, None

    J. Beal, None

    C. Somboonwit, Gilead Sciences: Speaker's Bureau, Speaker honorarium

    S. Mcintosh, None

    A. Bork, None

    M. Tinsley, None

    A. Cajina, None

    P. Belton, None

    J. Xavier, None

    R. Doshi, None

    R. Boyd, None

    N. Solomon, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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