ABSTRACT
Background: The role of telemedicine seems to be important in the management of hepatitis C virus (HCV) infected patients. Many studies have been conducted in prisons, drug addiction centres and more recently general population because of the COVID pandemic. However, evidence of effectiveness evaluated by randomized clinical trials is scarce but relevant to firmly promote telemedicine at drug addiction centres to achieve WHO 2030 elimination goals. Method(s): From Jul/2019 to Dec/2020, a total of 120 patients who attended one drug addiction centre were randomized (NCT04035980) into two groups: telemedicine strategy (including dry blood spot HCV RNA testing, HCV specialist videoconferencing with the patient, and onsite treatment and FIB-4 score calculation if RNA was positive) vs. conventional care strategy (included dry blood spot testing and referral to reference centre with the specialist if RNA was positive). Clinical variables were collected to assess the characteristics of patients in both strategies. Sustained virological response was assessed as a primary outcome. Additionally, among a patient subset, we administered a modified 10-item telemedicine satisfaction questionnaire. Result(s): We included 120 subjects (age 42.4+/-11.1, 85% male) with characteristics shown in the table. The number of included patients during the COVID pandemic (n=41) was similar in the telemedicine group and conventional group (31.7% vs 36.7%). Overall, 13 (10.8%) patients tested positive for RNA, 10 (9 in pre-pandemic time) in the telemedicine group vs. 3 (1 in pre-pandemic time) in the conventional group (p=0,050). All but one of the patients in the telemedicine group initiated treatment with direct-acting antivirals, whereas only one patient (33.3%) in the conventional group that was rescued with telemedicine after not showing up to the appointment with the specialist. Sustained virological response was documented in 90.9% of the patients. Patients who attended by telemedicine scored high on the satisfaction questionnaire. Conclusion(s): Our results showed telemedicine and onsite treatment delivery at drug addiction centres as the integrative model of care of choice to eliminate HCV from persons with substance use disorders. (Figure Presented).