Year 2021 / Volume 113 / Number 6
Original
Chronic viral hepatitis C micro-elimination program using telemedicine. The Mexican experience

432-435

DOI: 10.17235/reed.2020.7425/2020

José Luis Pérez Hernández, Rodolfo Lehmann Mendoza, Javier Luna Martínez, José Fernando Torres Roldán, Pedro Armando Chaidez Rosales, Hilario Ascención Martinez Arredondo, Verónica Rebollar González, Lourdes De la Cruz Silva, Daniel Santana Vargas, María de Fátima Higuera de la Tijera, C. Alejandro Arce Salinas,

Abstract
Background: hepatitis C virus (HCV) infection is a global health problem. Chronic infection induces the development of fibrosis and cirrhosis together with all the related complications. The use of direct-acting antiviral (DAA) drugs has proven highly effective. Telemedicine is a present-day resource that brings treatment closer to distant areas and may result in cost savings. Objective: to implement a microelimination program for HCV using DAAs with the support of a telemedicine program to minimize expenses. Patients and methods: the program was developed at the Medical Services department of Petróleos Mexicanos (SMPM) with a national coverage; patients diagnosed with chronic hepatitis C were included. These were classified into locals and outsiders. Treatment for foreign patients was indicated, monitored and completed via telemedicine. Thus, avoiding their travel to the country’s capital city, in order to save on transportation costs and travel allowances. Results: a total of 136 patients, 74 locals and 62 outsiders, participated in the study. Transfer was avoided for 62 patients (45.5 %), which meant that telemedicine resulted in savings of 3,176.20 USD per patient, with overall savings of 196,924.40 USD from cost minimization. A total of 30 patients remained untreated due to lack of medication, hence the coverage amounted to 86 %. Sustained virological response (SVR) was achieved in 99 % of cases. Only two patients had treatment failure. Adverse events included headache and fatigue in 5 % of the cohort. Conclusions: with the aid of a telemedicine approach, significant savings were achieved by minimizing costs, since nearly half of patients were outsiders. Coverage reached 86 % and treatment with DAAs was successful for 99 % of our cases.
Share Button
New comment
Comments
No comments for this article
References
1. WHO Global Hepatitis Report 2017. Available from: https:// www.who.int/hepatitis/publications/global-hepatitis-report2017/en/ (accessed: 21 September 2018).
2. Gutiérrez JP, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernández S, Franco A, Cuevas-Nasu L, Romero-Martínez M, Hernández-Ávila M. Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca, México: Instituto Nacional de Salud Pública (MX), 2012.
3. Hajarizadeh B, Grebely J, Dore GJ. Epidemiology and natural history of HCV infection. Nat Rev Gastroenterol Hepatol 2013; 10: 553-562
4. Manns M, Marcellin P, Poordad F, et al. Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 2014;384:414-26.
5. Aoki FY, Hayden FG, Dolin R. Antiviral drugs. Boceprevir y telaprevir. In: Mandell D and Bennett's (editors). Principles and Practice of Infectious Diseases, 7th ed. Churchill-Livingstone, Washington, 2010
6. Lisa I. Backus Derek B.Boothroy d Barbara R. Phillips Pamela Belperio James Halloran Larry A.Mole A Sustained Virologic Response Reduces Risk of All-Cause Mortality in Patients With Hepatitis C. Clin Gastroenterol Hepatol 2011 9:509-516.
7. World Health Organization. A health telematics policy in support of WHO’s Health-For-All strategy for global health development: report of the WHO group consultation on health telematics, 11-16 December, Geneva, 1997. Geneva, World Health Organization, 1998.
8. Marco Mouriño A, Da Silva Morán A, Ortiz Seuma J. et al. Predictors of adherence to treatment of chronic hepatitis C in drug-dependent Inmate Patients in four prisons in Barcelona, Spain Rev Esp Salud Pública 2010; 84: 421-429.
9. Bielen R, Stumo SR, Halford R, Werling K, Reic T, Stöver H, et al. Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries. Harm Reduct J. 2018;15.
10. Simona Onali,1 Ivana Maida,2 Cinzia Balestrieri,3 F et al. Safety and Efficacy of Direct-Acting Antivirals in Transfusion-Dependent Thalassemic Patients with Chronic Hepatitis C. Hepat Mon. 2018 January; 18(1):e61453.
11. P. A. M. Kracht, J. E. Arends, K. J. van Erpecum, A. Urbanus, J. A. Willemse, A. I. M. Hoepelman and E. A. Croes. Strategies for achieving viral hepatitis C micro-elimination in the Netherlands. Hepatology, Medicine and Policy (2018) 3:12.
Related articles

Editorial

Cases of liver disease lost in the health system: a call to action

DOI: 10.17235/reed.2021.8316/2021

Original

Active search for hepatitis C patients in primary care

DOI: 10.17235/reed.2021.8067/2021

Original

Hepatitis C in homeless people: reaching a hard-to-reach population

DOI: 10.17235/reed.2021.7737/2020

Editorial

Screening guide for hepatitis C virus infection in Spain

DOI: 10.17235/reed.2020.7728/2020

Special Article

Strategy for the Elimination of Hepatitis C in Cantabria

DOI: 10.17235/reed.2020.7108/2020

Editorial

Reflex testing. A key tool for the elimination of hepatitis C

DOI: 10.17235/reed.2020.7201/2020

Original

Quality of life study in asymptomatic patients with hepatitis C

DOI: 10.17235/reed.2019.6339/2019

Letter

Acute seronegative hepatitis C: two case reports

DOI: 10.17235/reed.2019.5921/2018

Citation tools
Pérez Hernández J, Lehmann Mendoza R, Luna Martínez J, Torres Roldán J, Chaidez Rosales P, Martinez Arredondo H, et all. Chronic viral hepatitis C micro-elimination program using telemedicine. The Mexican experience. 7425/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 487 visits.
This article has been downloaded 169 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 22/07/2020

Accepted: 04/10/2020

Online First: 03/12/2020

Published: 04/06/2021

Article revision time: 67 days

Article Online First time: 134 days

Article editing time: 317 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology