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 hepatitis C virus (HCV) and in treatment for opioid use disorders (OUD), highlighting the long-term impact of sustained virological response (SVR) and sobriety.1

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.2

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.

References

1. 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. 2025;28(5):e70404. https://doi.org/10.1111/hex.70404

2. Rosenthal ES, Silk R, Mathur P, et al. Concurrent Initiation of Hepatitis C and Opioid Use Disorder Treatment in People Who Inject Drugs. Clinical Infectious Diseases. 2020;71(7):1715-1722. https://doi.org/10.1093/cid/ciaa105