Telemedicine and hybrid engagement models facilitate hepatitis C cascade of care during periods of healthcare disruption.

INTRODUCTION AND

OBJECTIVES

To assess the utility of telemedicine in the provision of hepatitis C care, we compared characteristics and outcomes of HCV-infected patients engaging in standard in-clinic care, telemedicine only (TM), and hybrid (HB) models of care across pre-, peri‑ and post-COVID-19 pandemic periods.

PATIENTS AND

METHODS

HCV RNA-positive patients assessed between October 2017 and March 2025 at The Ottawa Hospital Viral Hepatitis Program (Ottawa, Canada) were retrospectively analyzed.

RESULTS

Of 1118 patients, 626 (56.0%) engaged in standard care, 139 (12.4%) in TM care, and 353 (31.6%) in HB care. TM group patients were less likely to have immigrated, experienced substance abuse, housing instability, incarceration, or psychiatric conditions, or be based in Ottawa. Utilization of HB and TM care was highest during the pandemic. Across all time periods, HB care demonstrated higher DAA treatment initiation and completion compared to standard or TM care (standard: 81.5 %; TM: 79.1 %; HB: 92.1 %, p < 0.01) and (standard: 91.3%; TM: 93.6%; HB: 96.3%, p = 0.02), respectively, with no difference in SVR. During the pandemic, a greater proportion of patients experiencing barriers to cure engaged in HB or TM care and achieved DAA completion (pre: 91.1%; pandemic: 98.1%; post: 95.8%, p < 0.01). HB care was associated with increased odds of DAA initiation (OR = 2.87; 95% CI 1.82 to 4.53), including patient populations experiencing barriers to cure (OR = 2.35; 95% CI 1.35 to 4.07).

CONCLUSIONS

HB models demonstrate potential in addressing public health challenges and engaging marginalized populations, supporting increased integration into HCV care programs.