Treatment of Hepatitis C Virus Infection: Is It Time for the Internist to Take the Reins?
Authors: Shyam Kottilil, Mary Wright, Michael A. Polis, Henry Masur
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions16 September 2014Treatment of Hepatitis C Virus Infection: Is It Time for the Internist to Take the Reins?Shyam Kottilil, MD, PhD, Mary Wright, MD, MPH, Michael A. Polis, MD, MPH, and Henry Masur, MDShyam Kottilil, MD, PhDFrom the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, Mary Wright, MD, MPHFrom the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, Michael A. Polis, MD, MPHFrom the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, and Henry Masur, MDFrom the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0741 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For the first time since the identification of hepatitis C virus (HCV) in 1988, communitywide eradication of HCV infection seems possible. With the U.S. Food and Drug Administration's approval in late 2013 of simeprevir and sofosbuvir, 2 direct-acting oral anti-HCV drugs, the time has come to launch major initiatives to reduce the effect of this infection on individuals and on our communities. Who should lead the charge to initiate and manage treatment: subspecialists, internists, or both?Globally, 230 million persons are infected with HCV, including 2.7 to 3.9 million persons in the United States (1, 2). Spontaneous resolution occurs in ...References1. Denniston MM, Jiles RB, Drobeniuc J, Klevens RM, Ward JW, McQuillan GM, et al. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. 2014;160:293-300. [PMID: 24737271] doi:10.7326/M13-1133 LinkGoogle Scholar2. Thomas DL. Global control of hepatitis C: where challenge meets opportunity. Nat Med. 2013;19:850-8. [PMID: 23836235] doi:10.1038/nm.3184 CrossrefMedlineGoogle Scholar3. Alavi M, Raffa JD, Deans GD, Lai C, Krajden M, Dore GJ, et al. Continued low uptake of treatment for hepatitis C virus infection in a large community-based cohort of inner city residents. Liver Int. 2013. [PMID: 24164865] doi:10.1111/liv.12370 CrossrefMedlineGoogle Scholar4. McGowan CE, Monis A, Bacon BR, Mallolas J, Goncales FL, Goulis I, et al. A global view of hepatitis C: physician knowledge, opinions, and perceived barriers to care. Hepatology. 2013;57:1325-32. [PMID: 23315914] doi:10.1002/hep.26246 CrossrefMedlineGoogle Scholar5. Lawitz E, Mangia A, Wyles D, Rodriguez-Torres M, Hassanein T, Gordon SC, et al. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med. 2013;368:1878-87. [PMID: 23607594] doi:10.1056/NEJMoa1214853 CrossrefMedlineGoogle Scholar6. Sulkowski MS, Gardiner DF, Rodriguez-Torres M, Reddy KR, Hassanein T, Jacobson I, et al; AI444040 Study Group. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370:211-21. [PMID: 24428467] doi:10.1056/NEJMoa1306218 CrossrefMedlineGoogle Scholar7. Kohli A, Osinusi A, Sims Z, Nelson A, Meissner EG, Barrett LL, et al. Directly acting triple-drug anti-HCV therapy induces complete virologic response with a six-week regimen: a proof of concept phase 2a cohort study. Lancet. 2014. Google Scholar8. Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364:2199-207. [PMID: 21631316] doi:10.1056/NEJMoa1009370 CrossrefMedlineGoogle Scholar9. Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis. 2013;57:1164-71. [PMID: 23797289] doi:10.1093/cid/cit420 CrossrefMedlineGoogle Scholar10. Hoofnagle JH, Sherker AH. Therapy for hepatitis C—the costs of success [Editorial]. N Engl J Med. 2014;370:1552-3. [PMID: 24725236] doi:10.1056/NEJMe1401508 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, and National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, Maryland.Financial Support: By the intramural program of the National Institutes of Health Clinical Center and National Institute of Allergy and Infectious Diseases.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0741.Corresponding Author: Henry Masur, MD, Critical Care Medicine Department, National Institutes of Health Clinical Center, 10 Center Drive, Room 2C145, Bethesda, MD 20892.Current Author Addresses: Dr. Kottilil: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10/11N204, Bethesda, MD 20892.Dr. Wright: Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 8 West Drive, MSC 2665, Building 15B1, Room 0204, Bethesda, MD 20892.Dr. Polis: Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Room 1118, 6700B Rockledge Drive, Bethesda, MD 20892.Dr. Masur: Critical Care Medicine Department, National Institutes of Health Clinical Center, 10 Center Drive, Room 2C145, Bethesda, MD 20892.Author Contributions: Conception and design: S. Kottilil, M.A. Polis, H. Masur.Analysis and interpretation of the data: S. Kottilil, M.A. Polis, H. Masur.Drafting of the article: S. Kottilil, M. Wright, M.A. Polis, H. Masur.Critical revision of the article for important intellectual content: S. Kottilil, M. Wright, M.A. Polis, H. Masur.Final approval of the article: S. Kottilil, M.A. Polis, H. Masur.Provision of study materials or patients: S. Kottilil.Statistical expertise: S. Kottilil.Obtaining of funding: S. Kottilil, H. Masur.Administrative, technical, or logistic support: S. Kottilil, H. Masur.Collection and assembly of data: S. Kottilil. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Hepatitis C Virus Infection Donald Venes Treatment of Hepatitis C Virus Infection Neeral L. Shah , Virginia Kelly , and Stephen H. Caldwell Treatment of Hepatitis C Virus Infection Michael P. Carson Treatment of Hepatitis C Virus Infection Shyam Kottilil , Mary Wright , Michael A. Polis , and Henry Masur Treatment of Hepatitis C Virus Infection Donald Venes Treatment of Hepatitis C Virus Infection Shyam Kottilil , Mary Wright , Michael A. Polis , and Henry Masur Treatment of Hepatitis C Virus Infection Michael P. Carson Treatment of Hepatitis C Virus Infection Neeral L. Shah , Virginia Kelly , and Stephen H. Caldwell Metrics Cited ByMandatory Hepatology Education for Internal Medicine Residents: Long‐Term Effects and Implications for Workforce NeedsUptake of and Factors Associated With Direct-acting Antiviral Therapy Among Patients in the Chronic Hepatitis Cohort Study, 2014 to 2015Global elimination of hepatitis C virus infection: Progresses and the remaining challengesExpansion of Treatment for Hepatitis C Virus Infection by Task Shifting to Community-Based Nonspecialist Providers A Nonrandomized Clinical TrialSarah Kattakuzhy, MD, Chloe Gross, RN, Benjamin Emmanuel, MPH, Gebeyehu Teferi, MD, Veronica Jenkins, MD, Rachel Silk, RN, MPH, Elizabeth Akoth, RN, MS, Aurielle Thomas, BA, Charisse Ahmed, BS, Michelle Espinosa, Angie Price, CRNP, Elana Rosenthal, MD, Lydia Tang, MD, Eleanor Wilson, MD, MS, Soren Bentzen, PhD, Henry Masur, MD, and Shyam Kottilil, MD, PhD, and the ASCEND Providers*Hepatitis B Virus Reactivation Associated With Direct-Acting Antiviral Therapy for Chronic Hepatitis C Virus: A Review of Cases Reported to the U.S. Food and Drug Administration Adverse Event Reporting SystemSusan J. Bersoff-Matcha, MD, Kelly Cao, PharmD, Mihaela Jason, PharmD, Adebola Ajao, PhD, S. Christopher Jones, PharmD, MS, MPH, Tamra Meyer, PhD, MPH, and Allen Brinker, MD, MSNovel educational interventions in residency increase knowledge of chronic liver disease and career interest in hepatologyFrequency of and Factors Associated with Receipt of Liver-Related Specialty Care Among Patients with Hepatitis C in the Chronic Hepatitis Cohort StudyEffects of Eradicating Hepatitis C Virus Infection in Patients With Cirrhosis Differ With Stage of Portal HypertensionToward the Effective Co-management of Patients with Cirrhosis by Primary Care Providers and SpecialistsRestrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United StatesSoumitri Barua, Robert Greenwald, JD, Jason Grebely, PhD, Gregory J. Dore, MBBS, PhD, Tracy Swan, and Lynn E. Taylor, MDA call to action: The need for hepatology-focused educational interventions in Internal Medicine Residency trainingTreatment of Hepatitis C Virus InfectionDonald Venes, MDTreatment of Hepatitis C Virus InfectionNeeral L. Shah, MD, Virginia Kelly, RN, and Stephen H. Caldwell, MDTreatment of Hepatitis C Virus InfectionMichael P. Carson, MD 16 September 2014Volume 161, Issue 6Page: 443-444KeywordsAllergy and immunologyDrugsHepatitis C virusInfectious diseasesInfectious hepatitisInterferonsLiver diseasesPatient advocacyPatientsSub-specialty care ePublished: 16 September 2014 Issue Published: 16 September 2014 PDF DownloadLoading ...