HCV De-Identified Data.docx
Creators: name: Ajayi, Ebun
name: Bobb, Raymond
Publisher: name: figshare
Year: 2022
Subjects: subject: Diseases
subject: 111716 Preventive Medicine
subject: FOS: Health sciences
subject: Medicine

description: Hepatitis C is one of the many complications of the ongoing opioid epidemic and injection drug use. Most injection drug users go untreated, increasing the risk of transmission, as well as the user’s risk of developing cirrhosis or liver cancer. Within Methadone Maintenance Treatment programs, many attendees are living with untreated Hepatitis C, and face providers who are unwilling to treat them due to their active use. In 2019, a single program in Philadelphia approached this challenge in rising Hepatitis C cases by developing an integrated health division, integrating the patient’s methadone maintenance with the treatment of their co-existing medical conditions. In addition to patients receiving methadone and therapy, patients are given the choice to receive treatment for Hepatitis C and other conditions within the provider’s scope of practice. The data was collected manually, utilizing a combination of the program’s electronic health record, patient paper charts, and data spreadsheets. Consent was collected from each patient prior to initiating treatment. What was recorded of each patient was their starting Hepatitis C viral load, Fibrosis Score, Genotype, HIV status, HBV status, and insurance status. We also collected the medical history of each patient, including past Hepatitis C treatment experience, allergies, and a full list of current medications to determine contraindication. Race, age, and amount of time in substance use treatment was also collected and documented of each patient. Data was collected daily on the patient’s treatment progress and completion status. The data includes the patients who started and finished treatment, discontinued treatment, or were lost to care mid-treatment. The data also includes the percentage of patients who completed their sustained virologic testing 12 weeks post-treatment. Key words: opioid, methadone, hepatitis c<br> <em>Introduction</em> Prior to 2019, a Methadone Maintenance Treatment program based in Philadelphia, Pennsylvania offered an expansive array of services to each patient, including medication assisted treatment, case management, and childcare. In December of 2019, this program expanded their medical services by offering and treating Hepatitis C. The program was motivated to treat Hep C due to the uptick in cases throughout the Philadelphia region, including an ample number of patients who attend the program daily, and were still active in their intravenous drug use. Patient’s hepatitis C treatment was tracked using their electronic health record. In addition to the health record, manual spreadsheets were utilized to track all patients who were engaged in treatment, lost to care, or who opted out of receiving treatment. All demographics were gathered, in addition to any medical comorbidities. <em>Materials and Methods</em> We reviewed the charts of 142 patients from one MMT program receiving maintenance treatment for opioid use disorder with either methadone or buprenorphine who started HCV treatment between December 01, 2019, and May 31, 2021. The program’s providers evaluated new and current patients for HCV treatment upon admission to the program and during routine appointments respectively. Eligible patients completed laboratory testing on-site immediately after their appointment. Patients receiving maintenance treatment with either methadone or buprenorphine were <strong>eligible</strong> for treatment. Patients actively using illicit drugs, that were previously treated for HCV and did not achieve a sustained virologic response or were previously treated and became reinfected were eligible for re-treatment. We <strong>excluded</strong> patients with decompensated cirrhosis, compensated cirrhosis with multiple comorbidities, and patients with medical conditions that were outside the provider’s scope of practice. Excluded patients received a referral to an outside provider. Data was collected daily to measure completion and cure status. Progress of the patient’s treatment was presented to the care team weekly, and treatment details were collected in both the patient’s electronic health record, and an Excel spreadsheet. <em>Dataset Validation</em> As this was a retrospective observational review, data was validated between the team of medical providers by cross-referencing the electronic health record with the paper health record of each patient. Lab data was also validated through laboratories such as Labcorp and Quest. <em>Disclosure Statement (conflict of interest statement)</em> There are no conflicts of interest to disclose. <em>Funding information</em> There was no financial support or funding for this data as the services provided to each patient is embedded within the program.