Andrew Talal, MD, is a Professor of Medicine and Founder/Director of the Center for Research and Clinical Care in Liver Disease at the State University of New York at Buffalo - School of Medicine and Biomedical Sciences.

Andrew Talal, MD

Facilitated Telemedicine Boosts Long-Term Recovery for Patients with HCV and OUD, with Andrew Talal, MD

New research reveals the benefits of facilitated medicine for patients impacted by 

 and in treatment for opioid use disorders (OUD), highlighting the long-term impact of sustained virological response (SVR) and sobriety.

Andrew Talal, MD, a professor of medicine at the University at Buffalo, presented the findings at the 

American Association for the Study of Liver Diseases (AASLD) The Liver Meeting 2025

. The data reports sustained improvements in patient health, recovery, and satisfaction 5 years after HCV cure when treated via facilitated telemedicine integrated into opioid treatment programs (OTPs).

“Building trust between the patient and the facilitator case manager, it was that trust that then enabled them to start the hepatitis C treatment and to continue it when there was a problem,” said Talal. “They knew who to talk to in getting treated. If there were certain logistical barriers, the case managers helped patients to overcome those barriers.”

The rising opioid epidemic runs parallel with the increasing rates of HCV infection, which affect a disproportionate number of people who inject drugs. Achieving SVR is a functional cure of HCV and eliminates transmission risk, thereby stopping further spread. Many barriers to care exist for those with OUD, including denial of access to HCV treatment due to stigma surrounding non-adherence and perceived risks of reinfection. In the study, OUD-specific barriers included competing healthcare priorities and insurance restrictions.

Previous studies have explored the positive impacts of receiving HCV therapy in conjunction with OUD treatment. Addressing drug use-related harms, including overdose deaths, while administering HCV treatment can be a method to engage patients in OTPs in their overall health. Facilitated telemedicine for HCV offers patients treatment options available directly within OTPs, highlighting convenience and accessibility.

“The facilitated telemedicine really integrates both a social component as well as a technical component,” said Talal. “Having a facilitator, a case manager, on site within the opioid treatment program really worked to build trust with patients. The technical component really comes from the ability to bring the hep C provider to that site, making it much more convenient for patients to engage in Hep C care at a place where they're already getting care treatment.”

Investigators conducted 2 focus group discussions (FGD) with 9 participants who had previously taken part in a randomized controlled trial of facilitated telemedicine and were actively enrolled in OTPs 5 years post-achieving SVR.

Participants had a mean age of 52.6 years (SD, 13.7), 66.6% were male, and 88.8% identified as White. Participants were engaged in the research process through a Patient Advisory Committee to provide individualized feedback on study conduct. The key endpoints were participant feedback to evaluate the long-term impact and sustainability to inform future policy development.

The 3 FGD themes were as follows: attitudes towards HCV and barriers to treatment among people with OUD; embracing facilitated telemedicine for HCV care integrated into OTPs; and experiencing long-term benefits from facilitated telemedicine across all aspects of HCV care and overall well-being.

Participants advocated for facilitated telemedicine’s convenience, empathetic clinicians, and “one-stop shop” approach.

According to Talal, the future of HCV treatment in patient populations includes universal screening and the application of the facilitated telemedicine model to other settings, such as rural healthcare environments.

Editor’s Note: Talal reports relevant disclosures at Abbott Laboratories, Novo Nordisk, AstraZeneca, Salix, Gilead Sciences, AbbVie, and Madrigal.

Papalamprakopoulou Z, Dang TH, Gonzalez CJ, et al. Long-Term Benefits Following Hepatitis C Cure Through Facilitated Telemedicine; Experiences of People With Opioid use Disorder Five Years After Achieving a Sustained Virological Response. 

Health expectations : an international journal of public participation in health care and health policy

Rosenthal ES, Silk R, Mathur P, et al. Concurrent Initiation of Hepatitis C and Opioid Use Disorder Treatment in People Who Inject Drugs. 

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Integrating facilitated telemedicine into opioid treatment programs led to SVR, improved patient satisfaction, and long-term health gains 5 years post-cure.


Experts discuss the Role of Advocacy Organizations in HBV

Role of Advocacy Organizations in Hepatitis B Virus

In recognition of May 19 as World Hepatitis Testing Day and the month of May as Hepatitis Awareness Month, we are launching our latest 

, which spotlights a conversation between subject matter experts on updates and unmet needs in the management of 

Although not discussed with the same frequency and urgency as 

 within public health circles, HBV represents a significant impact to public health globally and within the US, where an estimated 2.4 million are chronically infected, because unlike with HCV, there is no cure for these chronically infected patients. However, like HCV, the ongoing opioid crisis in the US has contributed to ballooning rates of acute hepatitis B infection in recent years and only 25% of infected individuals receive a diagnosis, according to the Hepatitis B Foundation.

In the final installment of our 6-part discussion on updates in HBV, the focus shifts toward the role of advocacy and community involvement in improving the care cascade for this disease. Nancy Reau, MD, asks moderator Chari Cohen, DrPH, MPH, to elaborate on the significance of advocacy efforts in prioritizing elimination initiatives and ensuring access to vaccination and treatment globally. Cohen emphasized the need to elevate the patient voice and preferences to better understand the lived experience of HBV and tailor management approaches accordingly.

Andrew Talal, MD, discusses the challenges faced in HBV diagnosis and treatment, particularly the complexity of the pathway, replication, and linguistic barriers for some patients. Cohen reinforced the importance of community-based organizations in providing culturally competent education and support services to improve disease awareness and management.

In this 6-part discussion, our group of experts tackles the following topics:

Advances in Pathophysiology of Hepatitis B Virus

Implications of HBV DNA Integration on Care

Improving Hepatitis B Screening and Vaccination

Therapeutic Pipeline Updates in Hepatitis B Virus

Role of Advocacy, Patient Voice in Hepatitis B Virus

Nancy Reau, MD: Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

Andrew Talal, MD: Professor of Medicine and Founder/Director of the Center for Research and Clinical Care in Liver Disease at the State University of New York at Buffalo - School of Medicine and Biomedical Sciences.

In this segment of our 6-part discussion on updates and unmet needs within the management of hepatitis B virus focuses on the role of advocacy and patient voice in HBV management.

Role of Advocacy, Patient Voice in Hepatitis B

Experts discuss Unmet Needs in Hepatitis B

Discussing Unmet Needs in Hepatitis B

The fifth in our 6-part series, moderator Chari Cohen, DrPH, MPH, asks Nancy Reau, MD, and Andrew Talal, MD, about unmet needs in HBV management. Reau emphasized the importance of the CDC and WHO's simplified screening and treatment guidelines. She stressed the need to identify patients unaware of their status and ensure regular monitoring and treatment for those diagnosed. Talal highlighted expanding treatment access through telementoring and telemedicine, especially for patients with digital and health literacy challenges. He suggested these approaches should be further explored and implemented.

Cohen added that navigating patients through care is vital and requires more funding. She noted that patients often feel excluded from treatment decisions. Cohen highlights how new WHO guidelines encourage involving patients in discussions about their treatment preferences, but also emphasized the present need to address the quality of life impacts in future management guidelines.

In this segment of our 6-part discussion on updates and unmet needs within the management of hepatitis B virus focuses on the most pressing unmet needs in HBV for 2024.

Discussing Unmet Needs in Hepatitis B for 2024

Experts discuss Therapeutic Pipeline Updates in Hepatitis B

Therapeutic Pipeline Updates in Hepatitis B

The fourth in our 6-part series, begins with moderator Chari Cohen, DrPH, MPH, asking Nancy Reau, MD, and Andrew Talal, MD about the future of HBV treatments. Reau highlights the effectiveness of existing antiviral therapies, emphasizing that while new treatments are desirable, current treatments are quite effective when used. Reau goes on to stress the importance of HBV vaccination as a preventative measure. Reau mentioned the exciting potential of novel therapies, such as gene editing, but expressed hesitancy around predicting which new approaches would be most successful.

Talal agreed with Reau on the effectiveness of current therapies and the importance of vaccination. He pointed out that the use of combination therapies and treatment duration are ongoing areas of investigation. Talal likened the future of HBV treatment to the multi-targeted approach used in HIV therapy, noting the development of entry inhibitors and treatments that boost the host immune response. 

In this segment of our 6-part discussion on updates and unmet needs within the management of hepatitis B virus focuses on updates in the therapeutic pipeline.

Andrew Talal, MD

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