Table 1.

Studies reporting on HCV treatment through telehealth.

Study (Year) Design	Aim of the Study	Time Frame	Condition	Participants Exposed	Intervention/Exposure	Comparison	Outcomes	Sum of Results and Conclusion
Case, 2019 [10] Observational, retrospective	To compare the rates of SVR between patients being treated in a CCVT telehepatology clinic versus a specialty care clinic (standard of care) in the era of DAAs.	Between 1 January 2014 and 31 December 2017	HCV infection	135	Telehepatology clinic consisted of clinic-to-clinic video telemedicine between the Denver VA Medical Center specialty clinic providers and patients located at one of six rural community-based outpatient clinics (CBOCs).	629	Sustained virological response (SVR) rates.	Hepatitis C treatment utilizing telehealth technologies to improve access to care does not negatively impact treatment outcomes compared with specialty care clinics in the era of DAAs.
Cooper, 2017 [11] Observational, retrospective	To evaluate whether telemedicine can facilitate the linkage of HCV-infected Canadians living in under-served and remote areas without access to HCV healthcare specialists.	Between January 2012 and August 2016	HCV infection	157	The patient and remote site TM nurse are linked by audio and video to The Ottawa Hospital site at which the HCV clinician, nurse, and allied health care providers are located.	1130	Pre-treatment access to biopsy, transient elastography (i.e., FibroScan), initiation and type of HCV antiviral treatment, and sustained virological response (SVR) rates.	TM patients initiated HCV therapy and achieved high SVR rates comparable to those obtained using traditional models of care.
Haridy, 2020 [12] Observational, retrospective	To evaluate outcomes of community-based treatment of hepatitis C virus (HCV) through a remote consultation process in the first 12 months.	Between 1 March 2016 and 28 February 2017	HCV infection	383	Remote consultation was defined as community-based treatment from a GP or hepatitis nurse in consultation with a tertiary center specialist through paper-based referral, fax, or verbal discussion, without in-person specialist consultation with the patient prior to treatment initiation.	None	Sustained virological response (SVR) rates.	Community-based management of HCV through remote specialist consultation can be an effective model of care.
Richter, 2022 [13] Observational, retrospective	To compare factors associated with HCV treatment success over the past decade in Israeli prisons, specifically the influence of DAAs and telemedicine.	From January 2010 to December 2020	HCV infection	139	The gastroenterology consultant and a nurse interview the prisoner using close-up cameras located at both sites with synchronous real-time patient management. The telemedicine facility consists of a computer with access to electronic patient data, including medical history, laboratory, and imaging results, as well as medical treatment.	134	Sustained virological response (SVR) rates.	Screening this high-risk population and using telemedicine for treatment can be an effective strategy for eliminating HCV from the prison population.
Rodrigues, 2021 [14] Observational, prospective	To assess qualitative and clinical outcomes in a clinical nurse consultant-led regional telehealth model.	From 1 April 2017 to 10 June 2020	HCV infection	24	Video-consult platform for clinical assessment of disease status, psychosocial assessment, clinic goal assessment.	None	Sustained virological response (SVR) rate at 12 weeks, cirrhosis monitoring and HCC surveillance, cost-effectiveness, overall patient satisfaction.	Clinical nurse consultant-led hepatitis C virus management via telehealth allows access to marginalized regional populations.
O’Brien, 2022 [15] Observational, retrospective	To provide further evidence on the effectiveness of telemedicine in HCV treatment in a large urban safety net hospital in the United States.	From 1 March 2019 to 23 July 2021	HCV infection	133	First, most appointments with HCV providers and all medication teaching visits with pharmacists were converted to telemedicine. Second, tests for liver fibrosis staging shifted from using in-person FibroScan® tests to FibroSURE or FIB-4 laboratory tests that could be completed at the medical center or at another location based on patient preference. Third, medication was dispensed by mail delivery, if possible, to further reduce the patients’ need to come in person.	170	Appointment type, fibrosis staging method used, abdominal ultrasound for hepatocellular carcinoma screening, appointment attendance, treatment initiation, and SVR status. Only patients eligible for SVR tests were included in SVR status.	Appointments via telemedicine, transitioning to blood test-based fibrosis scoring, and medication delivery by mail can serve as tools to increase access to HCV care and successful HCV treatment completion even after COVID restrictions are lifted.
Papaluca, 2019 [16] Observational, prospective	To evaluate the feasibility and efficacy of a novel model of care for HCV patients.	13-month period	HCV infection	55 (+8)	The use of information technology, including telemedicine and a central electronic medical record, a centralized pharmacy distribution with real-time prisoner tracking, and federal government policy supporting prisoner access to DAAs.	13 (+8)	Sustained virological response (SVR) rates.	Hepatitis C treatment using a decentralized, nurse-led model of care is highly effective and can reach large numbers of prisoners.
Syed, 2020 [17] Observational, retrospective	To evaluate the efficacy and feasibility of HCV treatment in the Department of Corrections (DOC) through telemedicine.	From June 2015 to December 2019	HCV infection	870	The purpose of telemedicine visits was to document compliance, tolerance, side effects, duration, and response to treatment.	None	Sustained virological response (SVR) rates.	HCV treatment in the DOC through telemedicine is achievable and highly effective, with overall 97% SVR, irrespective of the underlying GT or DAA regimen used, and can eliminate HCV in this microenvironment and reduce the overall burden of HCV.
Wirth, 2022 [18] Observational, retrospective	First, to determine what percentage of patients during an ECHO session received DAA recommendations. Second, to analyze how U.S. Indian Country ECHO provides holistic care beyond the scope of HCV treatment. Third, to determine how ECHO served this subset of patients at increased risk of complications.	From February 2017 to March 2021	HCV infection	718	ECHO virtual telehealth clinics used Zoom Video Communications© (Zoom, San Jose, California) to connect PCPs serving AI/AN patients to a multi-disciplinary team of specialists, including physicians, pharmacists, and nurse practitioners, who provided comprehensive treatment recommendations.	None	Percentage of patients during an ECHO session who received DAA recommendations; number and type of recommendations that are beyond the scope of DAA prescription.	Most patients presenting at an Indian Country ECHO received recommendations for HCV treatment from their PCP, along with recommendations beyond the scope of HCV. Indian Country ECHO telehealth clinic provides comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
Perez-Hernandez, 2021 [19] Observational, prospective	To implement a micro elimination program for HCV using DAAs with the support of a telemedicine program to minimize expenses.	Project started in January 2017	HCV infection	62	Virtual conferencing via telemedicine.	74	Cost estimations, sustained virological response (SVR) rates, treatment failure, adverse events.	With the aid of a telemedicine approach, significant savings were achieved by minimizing costs since nearly half of patients were distant from the study facility.
Arora, 2010 [20] Observational, prospective	To evaluate the efficacy and feasibility of the ECHO model.	Between 7 September 2004 and 29 February 2008 (genotype 1 or 4) or 15 August 2008 (genotype 2 or 3)	HCV infection	152	Community providers take part in weekly HCV clinics, called “knowledge networks,” by joining a video conference or calling into a teleconference line. Case-based discussions are supplemented with short didactic presentations by interdisciplinary experts to improve content knowledge.	84	Sustained virological response (SVR) rates.	The ECHO model is an effective way to treat HCV infection in underserved communities.

CCVT: clinic-to-clinic video telemedicine; DAA: direct-acting antivirals; CBOC: community-based outpatient clinics; SVR: sustained virological response; TM: telemedicine; GP: general practitioner; DOC: department of corrections; ECHO: Extension for Community Healthcare Outcomes; PCP: primary care providers; AI: American Indian; AN: Alaska Native.