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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 25 of 37 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation:
Yakovchenko V, Morgan TR, Chinman MJ .
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
Keywords:
Hepatitis, Chronic Conditions, Veterans
Wurcel AG, Reyes J, Zubiago J
"I'm not gonna be able to do anything about it, then what's the point?": A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail.
Despite national guidelines promoting hepatitis C virus (HCV) testing in prisons, there is substantial heterogeneity on the implementation of HCV testing in jails. IN this study, the investigators sought to better understand barriers and opportunities for HCV testing by interviewing a broad group of stakeholders involved in HCV testing and treatment policies and procedures in Massachusetts jails.
AHRQ-funded; HS026008.
Citation:
Wurcel AG, Reyes J, Zubiago J .
"I'm not gonna be able to do anything about it, then what's the point?": A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail.
PLoS One 2021 May 26;16(5):e0250901. doi: 10.1371/journal.pone.0250901..
Keywords:
Hepatitis, Vulnerable Populations, Screening, Prevention, Public Health, Social Stigma
Mabry-Hernandez I, O'Dowd N
Screening for hepatitis B virus infection in adolescents and adults.
This AHRQ-authored Putting Prevention Into Practice (PPIP) quiz is on the Hepatitis B virus (HBV) screening U.S. Preventive Services Task Force (USPSTF) recommendation. Only three questions are included with the answers at the end of the quiz. The questions are about 1) When to screen for HBV; 2) Who are the high-risk groups for HBV; and 3) Which country has the highest prevalence of HBV infection.
AHRQ-authored.
Citation:
Mabry-Hernandez I, O'Dowd N .
Screening for hepatitis B virus infection in adolescents and adults.
Am Fam Physician 2021 Apr 15;103(8):493-94..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Screening, Prevention, Case Study
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation:
Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords:
Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Kemme S, Stahl M, Brigham D
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. The investigators found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA.
AHRQ-funded; HS026510.
Citation:
Kemme S, Stahl M, Brigham D .
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
J Pediatr Gastroenterol Nutr 2021 Feb;72(2):194-201. doi: 10.1097/mpg.0000000000002940..
Keywords:
Children/Adolescents, Hepatitis, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Guidelines
Chou R, Blazina I, Bougatsos C
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors updated the 2014 hepatitis B virus (HBV) screening review in nonpregnant adolescents and adults to inform the USPSTF. They found no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
AHRQ-funded; 290201500009I.
Citation:
Chou R, Blazina I, Bougatsos C .
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Dec 15;324(23):2423-36. doi: 10.1001/jama.2020.19750..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Chabra S, Hofstetter AM
Timely hepatitis B birth dose receipt for newborns: within 24 hours.
In this paper, the authors discuss the importance of timely administration of the hepatitis B birth dose to achieve the national goal of zero perinatal hepatitis B transmission in the near future. They state that the necessity of capturing vaccination opportunities in diverse health care settings is clearly evident during the coronavirus pandemic.
AHRQ-funded; HS025470.
Citation:
Chabra S, Hofstetter AM .
Timely hepatitis B birth dose receipt for newborns: within 24 hours.
Hosp Pediatr 2020 Dec;10(12):e18-e20. doi: 10.1542/hpeds.2020-001255..
Keywords:
Newborns/Infants, Hepatitis, Vaccination
Edwards GC, Shipe ME, Smith L
Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation.
The objective of this study was to explore patient willingness to accept a kidney from Hepatitis C virus-infected donors compared to donors with active intravenous drug use and donors with longstanding diabetes and hypertension. Using electronic surveys, results showed that utilization of kidneys from Hepatitis C virus-infected donors to expand the donor pool appeared to be an acceptable option to patients.
AHRQ-funded; HS026122.
Citation:
Edwards GC, Shipe ME, Smith L .
Exploring patient willingness to accept hepatitis C-infected kidneys for transplantation.
BMC Nephrol 2020 Nov 10;21(1):473. doi: 10.1186/s12882-020-02114-y..
Keywords:
Hepatitis, Kidney Disease and Health, Transplantation
Kolak MA, Chen YT, Joyce S
Rural risk environments, opioid-related overdose, and infectious diseases: a multidimensional, spatial perspective.
The authors adapted a risk environment framework to characterize rural southern Illinois and to describe the relations of risk environments, opioid-related overdose, HIV, Hepatitis C, and sexually transmitted infection rates between 2015 and 2017. They identified pervasive risk hotspots in more populated locales with higher rates of overdose and HCV incidence, whereas emerging risk areas were isolated to more rural locales that had experienced an increase in analgesic opiate overdoses and generally lacked harm-reduction resources. They also found that at-risk areas were characterized with underlying socioeconomic vulnerability but in differing ways, reflecting a nuanced and shifting structural risk landscape.
AHRQ-funded; HS022433.
Citation:
Kolak MA, Chen YT, Joyce S .
Rural risk environments, opioid-related overdose, and infectious diseases: a multidimensional, spatial perspective.
Int J Drug Policy 2020 Nov;85:102727. doi: 10.1016/j.drugpo.2020.102727..
Keywords:
Rural Health, Opioids, Substance Abuse, Medication, Hepatitis, Risk, Behavioral Health
Mabry-Hernandez I, Yan LD
Screening for hepatitis B virus in pregnant women.
This case study involves a 33-year-old U.S.-born pregnant clinician presenting for a first prenatal visit. She was pregnant once, more than two years ago; at that time she screened negative for the hepatitis B virus (HBV). She reports that she received an HBV vaccination one year ago during a work-related physical examination.
AHRQ-authored.
Citation:
Mabry-Hernandez I, Yan LD .
Screening for hepatitis B virus in pregnant women.
Am Fam Physician 2020 Jan 15;101(2):115-16..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Hepatitis, Pregnancy, Women, Maternal Care, Screening, Pregnancy, Case Study
Chou R, Dana T, Fu R
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation:
Chou R, Dana T, Fu R .
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Mar 10;323(10):970-75. doi: 10.1001/jama.2019.20788..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Wang D
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
This study compared in-person and online training for dissemination of clinical evidence of HIV, HCV, and STD. The study used 250 clinicians completing four training courses in dual formats over a three-month period. Online training was the preferred format by clinicians.
AHRQ-funded; HS022057.
Citation:
Wang D .
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
Stud Health Technol Inform 2019 Aug 21;264:2003-04. doi: 10.3233/shti190756..
Keywords:
Human Immunodeficiency Virus (HIV), Hepatitis, Sexual Health, Evidence-Based Practice, Training, Patient-Centered Outcomes Research
Henderson JT, Webber EM, Bean SI
Screening for hepatitis B infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
In this research letter, the authors described their evidence update conducted to inform the USPSTF in updating its 2009 recommendation. They found that targeted resources are needed to ensure that case management is effectively implemented through health care that reaches vulnerable populations most at risk of perinatal transmission of hepatitis B virus (HBV), including women born in countries where HBV is endemic. They concluded that improving access to prenatal care, screening, and case management are among the strategies to help eliminate perinatal HBV infection in the United States.
AHRQ-funded; 290201500007I.
Citation:
Henderson JT, Webber EM, Bean SI .
Screening for hepatitis B infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
AHRQ-funded; 290201500007I..
Keywords:
Evidence-Based Practice, Hepatitis, Pregnancy, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF), Women
Rogal SS, Yakovchenko V, Waltz TJ
Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: year 2.
The goal of the evaluation described in this article was to assess how site-level implementation strategies from providers in the VA’s Hepatitis Innovation Team (HIT) Collaborative were associated with hepatitis C (HCV) treatment initiation and how the use of these strategies changed over time. Key HCV providers at each of the 130 VA sites was asked in two consecutive fiscal years to complete an online survey which examined the use of 73 implementation strategies; providers reported on whether or not the use of each implementation strategy was due to the HIT Collaborative. The number of veterans initiating treatment for HCV at each site was captured using national data. The strategies that were more likely to be used in the second year included promoting adaptability, sharing knowledge between sites, tailoring strategies to deliver HCV care, and using mass media. The total number of veterans initiating treatment was positively correlated with the total number of strategies used in both years. The authors conclude that their results suggest the measuring of implementation strategies over time is a useful way to catalog implementation of evidence-based practices over time and over multiple settings.
AHRQ-funded; HS019461.
Citation:
Rogal SS, Yakovchenko V, Waltz TJ .
Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: year 2.
Implement Sci 2019 Apr 8;14(1):36. doi: 10.1186/s13012-019-0881-7..
Keywords:
Evidence-Based Practice, Hepatitis, Implementation, Veterans
Lo Re VR, Zeldow B, Kallan MJ
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
This cohort study was conducted to determine if cumulative mitochondrial toxic nucleoside reverse transcriptase inhibitors (mtNRTI) use increased the risk of hepatic decompensation and death among patients coinfected with human immunodeficiency virus (HIV) and chronic hepatitis C virus (HCV). The findings suggest that cumulative mtNRTI use may increase the risk of hepatic decompensation and death in HIV/HCV coinfection and should be avoided when alternatives exist for HIV/HCV patients.
AHRQ-funded; HS018372.
Citation:
Lo Re VR, Zeldow B, Kallan MJ .
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
Pharmacoepidemiol Drug Saf 2017 Oct;26(10):1172-81. doi: 10.1002/pds.4258..
Keywords:
Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Patient Safety
McMahon BJ, Bruden D, Townsend-Bulson L
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
The researchers examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic infection. They found those infected with HCV genotype 3 to be at high risk for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
AHRQ-funded; HS000046.
Citation:
McMahon BJ, Bruden D, Townsend-Bulson L .
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
Clin Gastroenterol Hepatol 2017 Mar;15(3):431-37.e2. doi: 10.1016/j.cgh.2016.10.012.
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Keywords:
Hepatitis, Cancer, Kidney Disease and Health, Risk, Mortality
Schmajuk G, Tonner C, Trupin L
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Hepatitis B virus (HBV) reactivation in the setting of rituximab use is a potentially fatal but preventable safety event. The rate of HBV screening and proportion of patients at risk who receive antiviral prophylaxis in patients initiating rituximab is unknown. This study found wide variations in hepatitis B screening practices among patients receiving rituximab, resulting in unnecessary risks to patients.
AHRQ-funded; HS023558; HS024412.
Citation:
Schmajuk G, Tonner C, Trupin L .
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Medicine 2017 Mar;96(13):e6528. doi: 10.1097/md.0000000000006528.
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Keywords:
Hepatitis, Electronic Health Records (EHRs), Medication, Prevention, Patient Safety
Linas BP, Morgan JR, Pho MT
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
This study used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of treatment policies for interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 and to identify strategies that balance access with cost control. It found that among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes.
AHRQ-funded; HS022433.
Citation:
Linas BP, Morgan JR, Pho MT .
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
Open Forum Infect Dis 2017 Winter;4(1):ofw266. doi: 10.1093/ofid/ofw266.
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Keywords:
Hepatitis, Healthcare Costs, Healthcare Costs, Treatments
Saeed MJ, Olsen MA, Powderly WG
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
This study investigated the association of diabetes with risk of decompensated cirrhosis in patients with chronic hepatitis C (CHC). In a privately insured US population with CHC, the rates of decompensated cirrhosis per 1000 person-years were: 185.5 for persons with baseline cirrhosis and diabetes, 119.8 for persons with cirrhosis and no diabetes, 35.3 for persons with no cirrhosis and diabetes, and 17.1 for persons with no cirrhosis and no diabetes.
AHRQ-funded; HS019455.
Citation:
Saeed MJ, Olsen MA, Powderly WG .
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
J Clin Gastroenterol 2017 Jan;51(1):70-76. doi: 10.1097/mcg.0000000000000566.
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Keywords:
Chronic Conditions, Diabetes, Hepatitis, Risk
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation:
Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords:
Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Tetrault JM, Tate JP, Edelman EJ
Hepatic safety of buprenorphine in HIV-Infected and uninfected patients with opioid use disorder: the role of HCV-infection.
The purpose of this paper was to examine risk for buprenorphine (BUP)-associated hepatotoxicity among individuals with HIV and HCV. The authors found that liver enzymes and total bilirubin are rarely elevated in HIV-infected and uninfected patients receiving BUP, and that the risk of hepatotoxicity was greater in individuals infected with HIV, HCV, or HIV/HCV co-infection, who may benefit from increased monitoring.
AHRQ-funded; HS021112; HS018372.
Citation:
Tetrault JM, Tate JP, Edelman EJ .
Hepatic safety of buprenorphine in HIV-Infected and uninfected patients with opioid use disorder: the role of HCV-infection.
J Subst Abuse Treat 2016 Sep;68:62-7. doi: 10.1016/j.jsat.2016.06.002.
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Keywords:
Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Risk
Simons BC, Spradling PR, Bruden DJ
A longitudinal hepatitis B vaccine cohort demonstrates long-lasting hepatitis B virus (HBV) cellular immunity despite loss of antibody against HBV surface antigen.
The purpose of this paper is to determine long-lasting protection resulting from hepatitis B vaccine, despite loss of antibody against hepatitis B virus (HBV) surface antigen (anti-HBs). All participants tested positive for tumor necrosis factor α, interleukin 10, or interleukin 6 production by HBV surface antigen-specific T cells. No participant had evidence of breakthrough HBV infection. The authors concluded that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.
AHRQ-funded; HS000046.
Citation:
Simons BC, Spradling PR, Bruden DJ .
A longitudinal hepatitis B vaccine cohort demonstrates long-lasting hepatitis B virus (HBV) cellular immunity despite loss of antibody against HBV surface antigen.
J Infect Dis 2016 Jul 15;214(2):273-80. doi: 10.1093/infdis/jiw142.
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Keywords:
Hepatitis, Prevention, Vaccination
Donnelly JP, Franco RA, Wang HE
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Hepatitis C virus (HCV) infection is a growing problem, disproportionately affecting those born between 1945 and 1965. Here, we demonstrate the wide geographic reach and surveillance potential of emergency department-based screening and identify areas of elevated HCV infection in central Alabama that were socioeconomically disadvantaged compared with surrounding communities.
AHRQ-funded; HS013852.
Citation:
Donnelly JP, Franco RA, Wang HE .
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Clin Infect Dis 2016 Mar 1;62(5):613-6. doi: 10.1093/cid/civ984.
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Keywords:
Hepatitis, Screening, Emergency Department, Emergency Medical Services (EMS), Value
Ali M, Yopp A, Gopal P
A variant in PNPLA3 associated with fibrosis progression but not hepatocellular carcinoma in patients with hepatitis C virus infection.
This study evaluated the association between single nucleotide polymorphism (SNP) in PNPLA3 and fibrosis progression and development of hepatocellular carcinoma (HCC) among HCV-infected patients. The authors performed a secondary analysis of data from participants in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial. They concluded that, based on data from the HALT-C trial, the PNPLA3 CG/GG SNP at rs738409 is associated with fibrosis progression but not development of HCC in patients with HCV infection.
AHRQ-funded; HS022418.
Citation:
Ali M, Yopp A, Gopal P .
A variant in PNPLA3 associated with fibrosis progression but not hepatocellular carcinoma in patients with hepatitis C virus infection.
Clin Gastroenterol Hepatol 2016 Feb;14(2):295-300. doi: 10.1016/j.cgh.2015.08.018.
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Keywords:
Cancer, Hepatitis, Genetics
LaFleur J, Hoop R, Korner E
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
The researchers determined whether selected patient characteristics predicted discontinued therapy for reasons other than lack of efficcacy (non-LOE) using national databases of U.S. veterans. They found that predictors of greatest magnitude included comorbidities of myocardial infarction/congestive heart failure, renal disease, platelets 100/mm or more, Black race, albumin 3.5 mg/dl or more, sleep aid use, and poor persistence with antidepressants and antihypertensive agents.
AHRQ-funded; HS018582.
Citation:
LaFleur J, Hoop R, Korner E .
Predictors of early discontinuation of pegylated interferon for reasons other than lack of efficacy in United States veterans with chronic hepatitis C.
Gastroenterol Nurs 2015 Nov-Dec;38(6):417-28. doi: 10.1097/sga.0000000000000214.
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Keywords:
Chronic Conditions, Hepatitis, Medication, Patient Adherence/Compliance, Veterans
