Article (Scientific journals)
Hepatitis C infection: eligibility for antiviral therapies
Delwaide, Jean; El Saouda, R.; Gerard, Christiane et al.
2005In European Journal of Gastroenterology and Hepatology, 17 (11), p. 1185-1189
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Keywords :
hepatitis C; treatment; interferon alfa; cost; adverse events; epidemiology; contraindication
Abstract :
[en] Background Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects. Objectives To evaluate the proportion of HCV patients who are eligible for a treatment. Methods In a database comprising 1726 viraemic HCV patients, the files of 299 patients who presented to the same hepatologist for an initial appointment between 1996 and 2003 were reviewed. Results Patients' characteristics were age 43.1 +/- 15.6 years, 53% male and 92% Caucasian. The main risk factors were transfusion (43%) and drug use (22%). Genotypes were mostly genotype 1 (66%), genotype 3 (12%) and genotype 2 (10%). These characteristics were not different from those of the whole series of 1726 patients. A total of 176 patients (59%) were not treated, the reasons for non-treatment being medical contraindications (34%), non-compliance (25%) and normal transaminases (24%). In addition, 17% of patients declined therapy despite being considered as eligible, mainly due to fear of adverse events. Medical contraindications were psychiatric (27%), age (22%), end-stage liver disease (15%), willingness for pregnancy (13%), cardiac contraindication (7%) and others (16%). Only 123 patients (41%) were treated. A sustained viral response was observed in 41%. The treatment was interrupted in 16% for adverse events. Conclusions The majority of HCV patients are not eligible for treatment. This implies that, with current therapies, only 17% of patients referred for chronic HCV become sustained responders. Some modifications of guidelines could extend the rate of treatment (patients with normal transaminases), but an important barrier remains the patients' and the doctors' fear of adverse events.
Disciplines :
Gastroenterology & hepatology
Hematology
Author, co-author :
Delwaide, Jean ;  Université de Liège - ULiège > Gastro-Entérologie-Hépatologie
El Saouda, R.;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-entérologie
Gerard, Christiane ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie biologique et immuno hématologie
Belaiche, Jacques ;  Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Language :
English
Title :
Hepatitis C infection: eligibility for antiviral therapies
Publication date :
November 2005
Journal title :
European Journal of Gastroenterology and Hepatology
ISSN :
0954-691X
eISSN :
1473-5687
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
Volume :
17
Issue :
11
Pages :
1185-1189
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 February 2010

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