Non-Specialist Physicians Successfully Treat Hepatitis C Infection With Simplified Care Pathway in France

Abstract

To eliminate hepatitis C virus (HCV) infection in France, prescribing rights for sofosbuvir/velpatasvir (SOF/VEL) were extended to non-specialists, and a simplified care pathway for non-severe patients was implemented. Patients can thus be treated once diagnosis is confirmed (“Test and Treat” model). The study's objective was to describe the effectiveness and safety of SOF/VEL when prescribed in routine practice in France. This French multicenter, prospective, noninterventional study included adults with chronic HCV infection, treated with SOF/VEL for 12 weeks. Data on patient characteristics, fibrosis stage and HCV RNA were collected from medical charts. The primary endpoint was the proportion of patients with sustained virologic response 12 weeks post-treatment (SVR12). Secondary endpoints included safety profile, time between tests and treatment initiation, and demographics of treated patients. A total of 371 eligible patients received at least one dose of SOF/VEL: 77.4% were treated by specialists, and 22.6% by non-specialists. In the specialist group, more patients had ongoing comorbidities (29.6% vs. 7.1%), and advanced fibrosis (26.3% vs. 18.4%). In the non-specialist group, more patients reported alcohol consumption (39.3% vs. 34.4%) and drug abuse (23.8% vs. 16.4%). Among the 303 patients eligible for SVR12 analysis, SVR12 rates were nearly identical between the groups: 98.4% (95% CI: 95.84–99.36) with the specialists and 98.3% (95% CI: 91.14–99.71) with the non-specialists. Median time between positive PCR test and treatment initiation was 30 days in both groups. SOF/VEL was well tolerated, and adherence was high regardless of the prescriber. Non-specialists successfully treated chronic HCV infection with a simplified care pathway.