BUFFALO, N.Y. — Hepatitis C is a virus that can infect the liver. Doctors say it’s usually spread by blood-to-blood contact. In the past, it was spread by things like blood transfusions, but intravenous drug use has since become the predominant way it’s being transmitted.
When someone is infected by the virus through a non-sterile injection, it infects liver cells that continue to produce the virus. Experts say to compensate, the body’s response is to create scar tissue.
If hepatitis C is not treated, it can lead to the scarring of the liver that can lead to nodules which can develop into liver cancer, the complete scarring of the liver, and eventually death.
A new University at Buffalo study published in the Journal of the American Medical Association was conducted across the state and suggests a positive impact of telemedicine treatment for hepatitis C for those in opioid treatments.
Doctors say new treatments for hepatitis C were introduced in 2013. Dr. Andrew Talal, a professor of medicine at the University at Buffalo, says the treatments — all oral pills — are tremendously effective.
“Since almost everybody is cured who takes the medication for two to three months, there's really no reason not to be treated," said Talal. "The issue is really getting the treatments to populations that are most in need."
Talal says he and his team of researchers hypothesized that telemedicine could be a bridge. They designed a study to compare the impact of hepatitis C virus therapy via telemedicine for patients in opioid treatment programs and patients part of opioid treatment programs who were referred to a doctor for hepatitis C.
"All sites began with the off-site referral arm where patients were given a slip and asked to make an appointment to see a doctor in the community, hepatitis specialists in the community, and then every nine months, four sites switched to the telemedicine intervention," he said.
During a telemedicine visit, case managers also took blood samples to monitor the level of the virus in the blood. Researchers found that 90.3% of the patients in the facilitated telemedicine group were cured from hepatitis C, compared to 39.4% of those in the referral group. Dr. Talal says by cure he means the virus wasn’t detected in the bloodstream. They also followed patients for two years after their treatment and found that among those cured of hepatitis, there were minimal reinfections.
"What we think is happening is that by somebody taking the challenge ... taking on the challenge of hep C treatment ... by being willing to go through the treatment, and being successfully cured of the virus, it allows them to face other activities that they may never have even thought about facing," Talal said.
Talal says the real implication of the study is that by incorporating facilitated telemedicine into the opioid treatment program, it enabled the treatment of a disease that used to require specialty knowledge.
"So it allows us to think about offering this modality of treatment for a whole host of other entities that could be treated in the same setting," said Talal. "On the other side, it also, I think, offers an opportunity to think about other places where we might engage underserved populations."
Talal says that can happen through telemedicine in places like in their homes or facilities.