Abstract:
:The ECHO model was developed to expand access to medical care for populations with HCV infection in underserved areas. We aimed to compare HCV treatment outcomes in community-based clinics with the Austral University Hospital (AUH) and to assess improvement in physician knowledge and skills. In October 2015, we established an HCV ECHO clinic at the AUH in Buenos Aires. To evaluate the impact of this programme, we conducted a prospective cohort study comparing treatment for HCV infection at the AUH with healthcare providers from different Argentinean provinces. A survey evaluating skills and competence in HCV care was administered, and results were compared. The primary endpoint was sustained virologic response (SVR) and under direct-acting antivirals. Since the implementation of ECHO clinics, a total of 25 physicians participated in at least one session (median 10.0; IQR 3.0-18.0). SVR rates (n = 437 patients) were 94.2% (95% CI 90.4-96.8) in patients treated at AUH clinic (n = 227/242) and 96.4% (95% CI 92.7-98.5) in those treated at ECHO sites (n = 188/195), with a nonsignificant difference between sites, 2.2% SVR difference (95% CI -0.24-0.06; P = 0.4). We also found a significant improvement in all the evaluated skills and abilities. Replicating the ECHO model helped to improve participants' skills in the management of HCV achieving similar SVR rates. ECHO model was demonstrated to be an effective intervention able to multiply and expand HCV treatment, a critical barrier to access to care that needs to be solved if we are committed with WHO goals to eliminate HCV by 2030.
journal_name
J Viral Hepatjournal_title
Journal of viral hepatitisauthors
Mendizabal M,Ridruejo E,Ceballos S,Sixto M,Billordo A,Gadea C,Mengarelli S,Alonso C,Palazzo A,De María L,Bruno A,Perez D,Piñero F,Deltrozzo V,Mendoza C,Figueroa S,Manero E,Villa M,Barreyro F,Moreno V,Vilar J,Murdoi
10.1111/jvh.13172subject
Has Abstractpub_date
2019-11-01 00:00:00pages
1284-1292issue
11eissn
1352-0504issn
1365-2893journal_volume
26pub_type
杂志文章abstract::Among individuals with chronic hepatitis C virus (HCV) infection, approximately 30% of patients show persistently normal alanine aminotransferase (PNALT). Individuals with PNALT have been historically excluded from antiviral treatment. However, some studies have reported sudden worsening of disease in patients with PN...
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,评审
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journal_title:Journal of viral hepatitis
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