Access to Direct-Acting Antiviral Treatment for Hepatitis C Virus Among Veterans With Serious Mental Illness

Psychiatr Serv. 2020 Feb 1;71(2):192-195. doi: 10.1176/appi.ps.201900227. Epub 2019 Oct 16.

Abstract

Objective: This study examined whether serious mental illness is associated with initiating and with completing sofosbuvir-based treatment for hepatitis C virus (HCV) among veterans who started treatment after the Veterans Health Administration (VHA) received expanded funding for HCV care.

Methods: Administrative health care data from fiscal years 2016-2017 revealed 4,288 treatment-naïve patients with HCV, of whom 1,311 had initiated sofosbuvir-based treatment. Dependent variables were initiation and completion of ≥8 weeks of sofosbuvir treatment. Associations with serious mental illness were estimated with adjusted odds ratios from multivariable logistic regression analyses.

Results: No statistically significant differences were found in the proportion of veterans with and veterans without serious mental illness who initiated (p=0.628) or completed ≥8 weeks (p=0.301) of sofosbuvir treatment.

Conclusions: Veterans with and without serious mental illness initiated and completed sofosbuvir treatment at similar rates. The VA should continue to provide equitable access to HCV treatments and support medication adherence.

Keywords: Direct-acting antiviral treatment; Hepatitis C; Serious mental illness; Veterans issues.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • Female
  • Health Services Accessibility / economics*
  • Hepatitis C / drug therapy*
  • Hepatitis C / epidemiology*
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Sofosbuvir / therapeutic use
  • Treatment Outcome
  • United States / epidemiology
  • United States Department of Veterans Affairs
  • Veterans / psychology

Substances

  • Antiviral Agents
  • Sofosbuvir