Effectiveness of evaluation of antiviral therapy in patients with chronic hepatitis C using telemedicine technologies

• Maxim I. Gonik
• Nadezhda A. Shub
• Alexey O. Bueverov
• Nikita S. Kahnii
• Ekaterina A. Isaeva
• Natalia A. Barsukova
• Pavel O. Bogomolov
• Elena L. Bueverova

Abstract

To investigate the possibility of using telemedicine technologies (TMT) to assess the effectiveness of ongoing antiviral therapy in patients with chronic hepatitis C (CHC).

The aim of the study – to use TMT to assess the frequency of achieving a virological response in patients with CHC at the end of therapy.

Material and methods. Patients CHC and infected with genotype 1b HCV were monitored and randomly assigned to two groups. In the first group, treatment was conducted through six telemedicine consultations and one in-person visit to a day hospital per week. The telemedicine consultations utilized by internet platforms (https://www.doctis.ru or https://gostelemed.ru). In the second group, patients attended the day hospital daily for examinations by an infectionist. All patients underwent antiviral therapy for 12 weeks with combination of ombitasvir/paritaprevir/dasabuvir and ritonavir. We assessed key laboratory parameters and start and after twelve weeks of antiviral therapy. Additionally, we evaluated the rate of achieving sustained virologic response (SVR) at twelve weeks after the completion of treatment.

Results and discussion. The study involved 84 patients with CHC. Among these, 54 patients were assigned to the first group, while 30 were placed in the second group. The average duration of daily remote monitoring with telemedicine technology was recorded at 10±4 minutes. Within the first group, an average of 70±2 consultations and approximately 12±1 in-person examinations by an infectionist occurred over the course of 12 weeks of antiviral therapy. In this group, alanine aminotransferase (ALT) level normalized in 96% of patients, aspartate aminotransferase (AST) in 100%, gamma-glutamyl transferase (GGT) in 100%, and alkaline phosphatase (ALP) in 91%. In the second group, normalization rates were observed as follows: ALT in 97%, AST in 90%, GGT in 83%, and ALP in 87%. Statistically significant reductions were noted for all studied parameters within each group (p<0.05); however, no significant differences between the groups were identified (p>0.05). Regarding the achievement of SVR at twelve weeks post-completion of antiviral therapy, all patients attained complete eradication of HCV, with no statistically significant difference between the groups (p>0.05).

Conclusion. The use of TMT permits an evaluation of the frequency of achieving clinical outcomes in patients with CHC that is comparably effective to traditional face-to-face visits. In this context, it can be asserted that the integration of TMT into the provision of specialized medical care for patients with CHC is a rational approach.

Keywords: telemedicine technologies; chronic hepatitis C; virologic response

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