Clinicians focus on HCV screening, treatment, and eradication

This interview originally ran on our sister website, HCPLive.

Tatyana Kushner, MD, MSCE, is associate professor of medicine in the Division of Liver Diseases at the Icahn School of Medicine, in an interview during the recently held American Association for the Study of Liver Diseases (AASLD) The Liver Meeting 2023. At Mount Sinai, the Biden administration’s hepatitis C elimination plan, the role of physicians in addressing the issue, and disparities among patients affected by HCV were discussed.

“The goal is to create a national plan to work toward hepatitis C elimination, and within that proposed plan, there are specific aspects to address,” Kushner explained.

Components of the goal include providing easier access to medicines, improving the process from testing to treatment, and emphasizing the need for research, especially as it relates to the development of a hepatitis C vaccine. In addition to those elements, Kushner also described the role of physicians in eliminating HCV and emphasized the need for screening.

“If you’re seeing a patient, whether it’s in primary care or another health care setting, you need to screen them for hepatitis C. And this is really very important. Even if you’re not someone who sees many hepatitis C patients, it’s an important part of your health care maintenance that you need to get tested for,” Kushner said.

The difficulty in addressing the increasing prevalence of HCV lies in the inability of physicians to treat this difficult population. Kushner explained that easy-to-treat populations are not a problem, but that more attention and resources should be put into communities that are considered challenging to treat, including “people who are experiencing homelessness, people who use drugs.” “Those who are taking injections are included.” “Not having regular access to the health care system.” In addition to paying special attention to challenging populations, Kushner also stressed the importance of the “whole spectrum of care,” spanning from initial diagnosis to treatment and follow-up visits.

“There are just underlying inequities in terms of access to health care, and we need to work really hard to make sure that in addition to the disparities, we make sure that stigma is addressed and people are able to access health care.” Feel quite comfortable. If you’re in a setting where there’s a lot of stigma, and they’re also not comfortable with health care, it’s going to be impossible to address hepatitis C in this population,” Kushner explained.

Looking at HCV from a gender-based perspective, women who inject drugs have a higher risk of HCV than men, for reasons that Kushner described as “multifactorial”, in part due to high-risk injection behavior. taking, high frequency of injection and stigma associated with stalking. Harm reduction services. Screening and treatment during pregnancy may provide new opportunities for female patients to engage in care they might not otherwise seek.

“Pregnancy is a time when women are coming to you, they’re engaged in care, and they’re already having all this testing, so this is our chance to screen them and also make sure they’re getting the treatment they need.” Are connected to. The question of treatment during pregnancy is still under consideration. “There is actually data at this meeting that shows the treatment looks promising in the second and third trimester,” Kushner said. “There’s obviously an important interaction with liver disease and pregnancy and pregnancy outcomes, so I think it’s really becoming part of what we’re doing, and I think the first guidance we have is There is a proof of this.”