Practice Brief A Practical Approach and Model of Care for HCV Treatment With Direct Acting Antivirals in an Urban Setting Elizabeth Akoth, RN, BSN, MSN* Chloe Gross, RN, BSN, ACRN Rachel Silk, RN, BSN, MPH Elana Rosenthal, MD Sarah Kattakuzhy, MD Key words: DAA, HCV, HCV Coordinator, SVR12 The U.S. Food and Drug Administration’s (FDA) approval of highly efficacious and tolerable direct- acting antivirals (DAAs) has led to a cure of hepatitis C virus (HCV) in many patients. The American Association for the Study of Liver Diseases (AASLD) and Infectious Disease Society of America (IDSA) guidelines recommended HCV treatment for all patients with chronic HCV regardless of disease stage (AASLD and IDSA, 2016). In contrast, a summary report by the Center for Evidence-Based Policy (2016) showed that many state Medicaid plans restricted treatment to patients with Stage 2 or higher liver disease. In the general population, barriers such as the high cost of DAAs, insurance restrictions, and lack of provider availability left many without treat- ment (IDSA and AASLD, 2016). Despite the avail- ability of DAAs, the uptake of these medications remained low, even in health systems such as the U.S. Veterans Administration, where there were no restrictions to medication acquisition. The Veterans Administration reported that, as of 2013, approxi- mately 174,000 veterans had been diagnosed with HCV infection, but at least 124,000 veterans had yet to be treated (Moon, Green, Berry, & Ioannou, 2016). The District of Columbia (DC) continues to be disproportionately affected by HIV and HCV. As of December 2015, at least 13,391 DC residents were living with HIV, roughly 2% of the Washington, DC, population. Approximately 18,000 residents had a pos- itive lab report for chronic HCV between 2011 and 2015 (District of Columbia Department of Health: HIV/AIDS, Hepatitis, STD and TB Administration, 2016), translating to 3% of the District’s population. In an effort to respond to the ongoing HCV epidemic, the DC Partnership for HIV/AIDS Progress team Elizabeth Akoth, RN, BSN, MSN, is a Research Lead Specialist, Institute of Human Virology, University of Maryland School of Medicine Baltimore, Maryland, USA, and a Special Volunteer, National Institutes of Health, Bethesda, Maryland, USA. (*Correspondence to: elizabeth.akoth@nih.gov). Chloe Gross, RN, BSN, ACRN, is a Research Lead Specialist, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA, and a Special Volunteer, National Insti- tutes of Health, Bethesda, Maryland, USA. Rachel Silk, RN, BSN, MPH, is a Clinical Nurse Administrator, Institute of Human Virology, University of Maryland School of Med- icine, Baltimore, Maryland, USA, and a Special Volunteer, National Institutes of Health, Bethesda, Maryland, USA. Elana Rosenthal, MD, is an Assistant Professor, Institute of Human Virology - Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland USA, and a Special Volunteer, National Insti- tutes of Health, Bethesda, Maryland, USA. Sarah Katta- kuzhy, MD, is an Assistant Professor, Institute of Human Virology - Division of Infectious Diseases University of Maryland School of Medicine Baltimore, Maryland, USA, and a Special Volunteer, National Institutes of Health, Bethesda, Maryland, USA. JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. -, No. -, -/- 2017, 1-5 http://dx.doi.org/10.1016/j.jana.2017.04.007 Copyright Ó 2017 Association of Nurses in AIDS Care