Table 1 Mechanisms to address gaps in treatment cascade [16, 23]
From: Under one roof: identification, evaluation, and treatment of chronic hepatitis C in addiction care
Cascade step | Outpatient addiction treatment site advantages | Cascade step eliminated |
|---|---|---|
1. Patients are diagnosed and aware of their infection | Standardized screening of all patients and counseling with results | |
2. Linkage to care (Access to outpatient care) | HCV care remains at the site | ✓ |
3. Confirmatory testing for HCV RNA | Standardized reflex testing | ✓ |
4. Liver disease evaluation, including liver biopsy (Note: Liver biopsy is not required for all patients) | Blood-based biomarker testing, a recommended alternative to liver biopsy, can be readily performed on site | ✓ |
5. Prescribed HCV treatment | Prescribed on site with coordination from specialty pharmacies | ✓ |
6. Achieved a sustained virologic response (SVR), also referred to as being cured | SVR testing done on site | ✓ |