Individuals living in homeless shelters seeking antiviral therapy for hepatitis C are generally satisfied with the level of care they receive, according to study results published in the Journal of Viral Hepatitis.

Gaining insight into patients’ experiences with treatment for hepatitis C virus (HCV) is critical for reaching disenfranchised or otherwise disadvantaged groups. But for unhoused individuals seeking antiviral therapy, such data on patient-reported experience are missing.

So Mandana Khalili, MD, of the University of California, San Francisco, and colleagues evaluated various measures of patient-reported experiences with direct-acting antiviral therapy for hepatitis C at several homeless shelters in San Francisco and Minnesota.

Across four homeless shelters, the researchers assessed the patient-reported experiences of 66 individuals who received antiviral therapy between November 2018 and April 2020.

The following measures were checked: satisfactory communication with the treatment provider, receipt of social support during antiviral therapy, perception of stigma linked to hepatitis C and overall satisfaction with the treatment.

Among the study population, 41 individuals completed the survey at the end of therapy, resulting in a response rate of 62%. The median age of the group was 56 years, and 74% were men. The population was diverse: 45% were Black, 44% were white and 6% were Latino. Further, 35% had an education level beyond that of high school. Some 65% had a history of injection drug use, while 56% had received treatment for substance use disorders. Moreover, 12% of the study population were also living with HIV.

While receiving antiviral therapy for hepatitis C, most individuals lived in homeless shelters, 37% used illegal drugs, 24% consumed alcohol and 14% received psychiatric therapy.

On assessing patient-reported experiences with antiviral therapy, the researchers found that 100% found their treatment providers to be nonjudgmental; indeed, 98% reported that their provider appeared to care about them. Around 98% reported that people close to them had been supportive of their care. On the whole, 98% were satisfied with their treatment for hepatitis C. The researchers did not identify any patient or clinical factors to help predict patient-reported experiences of stigma, social support deficiencies or satisfaction with antiviral therapy.

“Nearly all (>95%) homeless patients receiving integrated HCV testing and therapy within homeless shelters felt supported and reported favorable views toward their providers and a high level of satisfaction with [direct-acting antiviral] treatment,” wrote the researchers. “As patient-reported experience is key for engagement in HCV therapy, our onsite treatment intervention within shelters can serve as a model of HCV care to enhance treatment uptake in patients experiencing homelessness.”

Click here to read the study in the Journal of Viral Hepatitis.

Click here to learn more about treatment for hepatitis C.