Abstract

Background: Hepatitis C Virus (HCV) is a blood-borne viral pathogen resulting in hepatic inflammation that – if left untreated – may lead to advanced liver disease, hepatocellular carcinoma, and death. With the advent of improved treatment modalities, several national, state, and local governing bodies have called for HCV eradication. In March of 2023, the United States Presidential Administration announced plans to start a National Hepatitis C Elimination Program. This five-year plan, budgeted to start in the Fiscal Year 2024, will focus on access to diagnostic testing and HCV treatment along with comprehensive public health efforts. From a state level, HCV remains prevalent in Ohio with the ongoing opioid epidemic. To help improve access to HCV treatment, the Ohio Department of Health created the Hepatitis Surveillance Program and Hepatitis Prevention Initiative. Despite this, OhioHealth – a large healthcare system of 15 hospitals and affiliate organizations in Central Ohio – did not have ambulatory hepatology services until January of 2023. During the inception of the OhioHealth Comprehensive Liver Program, clinicians developed a pharmacist-led, referral-based viral hepatitis clinic to expand access to HCV treatment throughout Ohio. This quality improvement project under a collaborative practice agreement looks to evaluate the program’s success while also spreading best practices.

Methods: This project assessed all patients referred to the OhioHealth Viral Hepatitis Clinic since the program's inception in January 2023. Data was collected via manual, retrospective chart review. Descriptive statistics were performed to assess the data.

Results: Since January of 2023, 70 adult (average age: 46.8 years), HCV-infected patients have followed with the program. Of these 70 patients, 81.4% were white and 57.1% were female. The most common means of viral acquisition was intravenous drug exposure (62.9%). Most were treatment-naïve (91.4%), genotype 1a (48.6%) and non-cirrhotic (74.3%). Two patients (2.9%) had HBV coinfections while none had concurrent HIV. Most patients received either an 8- or 12-week course of treatment (85.7%). Patients initiated treatment within an average of 8.9 days of their first pharmacist visit. Patients were not required to visit with the pharmacist while on-treatment; however, they will complete 12-week post-treatment assessments.

Conclusion: This pharmacist-led, referral-based viral hepatitis clinic has been very successful and well received thus far in our large healthcare network with the goal of achieving HCV elimination. All outcomes data will be available and presented at AASLD’s Liver Meeting in November of 2023.