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Expanding Treatment Access for Chronic Hepatitis C with task-shifting in the Era of Direct-acting Antivirals

Journal of Clinical and Translational Hepatology 2017年第2期5卷 130-133页

作者： Eric R.Yoo Ryan B.Perumpail George Cholankeril Channa R.Jayasekera Aijaz Ahmed Department of Medicine University of Illinois College of Medicine Chicago IL USA Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford CA USA Division of Gastroenterology and Hepatology University of Tennessee Health Sciences Center Memphis TN USA Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford CA USA Center for Innovation in Global Health Stanford UniversityStanford CA USA

In the United States,the fight to eradicate hepatitis C virus (HCV) infection has been ongoing for many years,but the results have been less than ***,patients with chronic hepatitis C (CHC) were treated with interferon-based regimens,which were associated with frequent adverse effects,suboptimal response rates,and long durations of treatment-of up to 48 *** from specialistphysicians,such as hepatologists and gastroenterologists,was needed to closely follow patients on these medications so as to monitor laboratory values and manage adverse ***,the emergence of direct-acting antiviral (DAA) agents against HCV infection have heralded outstanding progress in terms of safety,tolerability,lack of adverse effects,efficacy,and truncated duration of therapy-12 weeks or less-thereby making the need for close monitoring by specialist-physicians *** the recent approval of DAA agents by the Food and Drug Administration,the treatment model for CHC no longer relies on the limited number of specialist-physicians,which represented a major barrier to treatment access in the past,especially in underserved areas of the United *** propose and share our experiences in adapting a task-shifting treatment model,one that utilizes a relatively larger pool of non-specialist healthcare providers,such as nursing staff (medical assistants,vocational licensed nurses,registered nurses,etc.) and advanced practice providers (nurse practitioners and physician assistants),to perform a variety of important clinical functions in an effort to make DAA-based antiviral therapy widely available against HCV *** recently,task-shifting was implemented by the United States and World Health Organization in the fight against the human immunodeficiency virus and showed encouraging *** on our experiences in implementing this model at our outreach clinics,the majority of HCV-infected patients treated with DAA agents can be easily monitored by

关键词： task-shifting Treatment Access Underserved Under-resourced Hepatitis C virus HCV Direct acting antivirals DAAs

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