gms | German Medical Science

Chronic hepatitis C virus (HCV) infection is a large public health burden and the commonest cause of liver transplantations in the United States. We are reporting a free clinic’s cost effective results of treatment of 49 patients with chronic hepatitis C (using telaprevir/ peg interferon /ribavirin for genotype 1 and peg interferon/ribavirin for genotypes 2, 3 and 4) within a 2 year period.

Among the 49 patients who started treatment, 42 completed the therapy with 36 (85%) attaining SVR at 24 weeks (End of therapy). Of the17 patients that had HCV fibrosure blood test done prior to therapy, 12 achieved SVR at 24 weeks. 4 out of 5 patients with Fibrosis score F0 (No fibrosis) and 2 out of 3 patients with fibrosis score F4 (Cirrhosis) attained SVR at end of treatment (24 weeks), 3 months, 6 months and 1 year after treatment respectively.

The commonest side effects were blood dyscrasias with leucopenia, managed with Granulocyte Colony Stimulating Factor, G-CSF, seen in 78% of patients treated. Rare side effects included retinopathy (managed by reducing interferon dose) and interstitial fibrosis (managed with oral corticosteroids).

In all, within a 24 month period, $300,000 provided via Lower Income Pool grants from the state was spent in patient care. This included clinical evaluation of patients that could not commence treatment at that point in time due to various reasons including contraindication to treatment. In conclusion, compared to an estimated $100,000 for treatment of a single patient with these medications and over $500,000 for a liver transplant, it is still possible through community empowerment, team work, and volunteerism to develop a cost effective model with successful results in treating patients with chronic HCV.