Increasing Access to Hepatitis C Treatment Using a Community-Based Multidisciplinary Approach

Leigh, Elaine A.

Saturday, 29 October 2011

Elaine A. Leigh, MSN, FNP-BC
Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI

Learning Objective 1: The learner will be able to identify the most common barriers to hepatitis C treatment.

Learning Objective 2: The learner will be able to identify the benefits of instituting a multidisciplinary approach to hepatitis C treatment.

Hepatitis C virus (HCV) is the most common blood-borne infection in the United States and it carries with it an estimated financial burden of 10.7 billion. HCV ranks as the leading cause of liver disease according to the National Institutes of Health. Infection with the hepatitis C virus is complex and individuals can remain asymptomatic for extended periods of time, making accurate prevalence rates difficult to estimate. According to the Centers of Disease Control and Prevention, 3.2 million people are affected with HCV within the US and worldwide totals approximate 170 million. Yet in spite of the burden of HCV, dedicated programs for HCV screening, diagnosis, and treatment are relatively uncommon.

HCV exposure results in a chronic infection in approximately 85% of individuals and 10-20% of those will develop cirrhosis. Chronic hepatitis C accounts for 8,000-10,000 death per year. Vulnerable and disadvantaged populations are at the highest risk for development of HCV because of their more frequent association with risky behaviors. Positive HCV virology may be found in up to 95% intravenous drug users and as many as 20-30% of persons with mental illness. The primary goal of HCV treatment is sustained eradication of virus which leads to a reduced progression to hepatic fibrosis, decompensated cirrhosis, or carcinoma of the liver.

HCV treatment lasts 6 to 12 months depending on viral genotype. Monitoring of laboratory values, side effects, and medication compliance is time intensive and requires dedicated and informed providers to manage HCV therapy. Nurse practitioners working in collaboration with physician partners in infectious disease, psychosocial services, pharmaceutical services, and primary care providers can offer HCV education and support with individualized treatment management and achieve better outcomes. This Multidisciplinary approach to will increase effective treatment for greater numbers of people in vulnerable populations with hepatitis C.

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