Psychosocial factors are the most common contraindications for antiviral therapy at initial evaluation in veterans with chronic hepatitis C.

Abstract:

GOALS:To understand the degree to which psychosocial factors were preventing veterans with chronic hepatitis C virus from being eligible for antiviral treatment. BACKGROUND:Nearly 2% of the US population is infected with hepatitis C. Antiviral treatment requires substantial adherence despite challenging side effects. Psychosocial factors, including depression and substance abuse, are clinically recognized contraindications for antiviral treatment. STUDY:At the Houston Veterans Affairs Medical Center HCV Clinic, we prospectively gathered medical and psychosocial data, as well as treatment disposition data, for consecutively referred patients who had screened positive for hepatitis C by enzyme-linked immunosorbent assay serology. RESULTS:Of the 697 patients referred from September 2000 to May 2001, 580 had chronic hepatitis C. The mean age was 51 years, and 99% were men. Psychosocial contraindications prevented hepatitis C antiviral treatment from being started for 406 (70.0%) patients. These contraindications included alcohol abuse (124, 21.4%), substance abuse (21, 3.6%), and depression (93, 16.0%). Among the medical contraindications were end-stage liver disease (34, 5.9%) and poorly controlled diabetes mellitus (20, 3.4%). CONCLUSION:Overall, our experience was that a significant portion of hepatitis C patients could not initially be started on antiviral treatment due to psychosocial factors. To make these patients eligible for treatment, future studies of multidisciplinary interventions are required.

journal_name

J Clin Gastroenterol

authors

Rowan PJ,Tabasi S,Abdul-Latif M,Kunik ME,El-Serag HB

doi

10.1097/01.mcg.0000123203.36471.70

subject

Has Abstract

pub_date

2004-07-01 00:00:00

pages

530-4

issue

6

eissn

0192-0790

issn

1539-2031

pii

00004836-200407000-00012

journal_volume

38

pub_type

杂志文章
  • Immunohistochemical study of sulfatide expression in gastric carcinoma: alteration of sulfatide expression.

    abstract::Immunohistochemical staining using a specific monoclonal antibody against sulfatide was performed to examine cellular localization of sulfatides in normal human gastric mucosa and in various types of gastric carcinoma. In normal gastric mucosa without Helicobacter pylori infection, both epithelial and glandular cells ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199700001-00023

    authors: Osawa H,Sugano K,Igari T,Tai T,Iwamori M,Kawakami M

    更新日期:1997-01-01 00:00:00

  • Serous cystadenoma in communication with the pancreatic duct: an unusual radiologic and pathologic entity.

    abstract::Cross-sectional imaging is frequently used in the diagnosis of pancreatic cysts, but there can be overlap in radiographic appearance. We present a case of a patient with presumed intraductal papillary mucinous neoplasm (IPMN) who was ultimately found to have a serous cystadenoma in communication with the pancreatic du...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e3181d3458d

    authors: Berman L,Mitchell KA,Israel G,Salem RR

    更新日期:2010-07-01 00:00:00

  • Treatment of benign chronic gastric ulcer with ranitidine. A randomized, double-blind, and placebo-controlled six week trial.

    abstract::A randomized, multicenter, double-blind, placebo-controlled study was conducted to determine whether ranitidine 150 mg b.i.d. for 6 weeks would expedite endoscopic healing or relief of symptoms in patients with benign gastric ulcer. Of 203 patients enrolled, 101 received ranitidine and 102 received placebo. Endoscopic...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004836-198606002-00008

    authors: Hirschowitz BI,DeLuca V,Graham D,Lorber S,Bright-Asare P,Katon R

    更新日期:1986-06-01 00:00:00

  • The prevalence and efficacy of ganciclovir on steroid-refractory ulcerative colitis with cytomegalovirus infection: a prospective multicenter study.

    abstract:BACKGROUND:It remains controversial whether or not cytomegalovirus infection in patients with active ulcerative colitis reflects a nonpathogenic colonization or a pathogenic disease warranting antiviral therapy. GOALS:The aim of this study was to determine the prevalence of cytomegalovirus infection in patients with a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/MCG.0b013e3182160c9c

    authors: Kim YS,Kim YH,Kim JS,Cheon JH,Ye BD,Jung SA,Park YS,Choi CH,Jang BI,Han DS,Yang SK,Kim WH,IBD Study Group of the Korean Association for the Study of Intestinal Diseases.

    更新日期:2012-01-01 00:00:00

  • Positive predictive value of endoscopic features deemed typical of gastric fundic gland polyps.

    abstract:BACKGROUND:Fundic gland polyps (FGPs) are now the most common gastric polyp encountered by endoscopists. However, they have minimal clinical significance. If they could be reliably predicted by endoscopic features, it might prevent the need for and cost of biopsy. GOALS:To determine the positive predictive value of en...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200305000-00007

    authors: Weston BR,Helper DJ,Rex DK

    更新日期:2003-05-01 00:00:00

  • Early recognition of toxic megacolon.

    abstract::Increased amounts of small bowel gas are a frequent finding on plain abdominal films in toxic megacolon (TMC), but they may also be found in patients with severe colitis. We studied 69 consecutive patients with severe ulcerative colitis to evaluate whether an increased gas content of the small intestine may identify p...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198704000-00010

    authors: Caprilli R,Vernia P,Latella G,Torsoli A

    更新日期:1987-04-01 00:00:00

  • Endoscopic and surgical therapy for intrahepatic cholangiocarcinoma in the united states: a population-based study.

    abstract:BACKGROUND:Intrahepatic cholangiocarcinoma (ICC) is a highly fatal disease with limited therapeutic options. The determinants, trends, and outcomes of different therapies for ICC are largely unknown in the United States. METHODS:Using data from the Surveillance, Epidemiology, and End-Results-(SEER) Medicare database, ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31802f3132

    authors: Shaib YH,Davila JA,Henderson L,McGlynn KA,El-Serag HB

    更新日期:2007-11-01 00:00:00

  • Younger hepatocellular carcinoma patients have better prognosis after percutaneous radiofrequency ablation therapy.

    abstract:GOALS:To evaluate the impact of age on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing percutaneous radiofrequency ablation (RFA). BACKGROUND:Whether age plays an important role in the outcomes of HCC after RFA remains controversial. STUDY:Two hundred fifty-eight consecutive treatment naive H...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31822b36cc

    authors: Kao WY,Chiou YY,Hung HH,Su CW,Chou YH,Huo TI,Huang YH,Wu WC,Lin HC,Lee SD,Wu JC

    更新日期:2012-01-01 00:00:00

  • Calcium and acid rebound: a reappraisal.

    abstract::We review acid rebound, the seemingly paradoxical increase in acid secretion resulting from administration of an antacid. Primarily a laboratory observation, the demonstration of the phenomenon was a major contributing factor to the swift, and possibly unjustified, fall from grace of calcium carbonate in the therapy o...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.1097/00004836-199207000-00010

    authors: Hade JE,Spiro HM

    更新日期:1992-07-01 00:00:00

  • Esophageal Function Abnormalities in Patients With Barrett's Esophagus.

    abstract::Various esophageal functional abnormalities have been described in patients with Barrett's esophagus (BE). A significantly higher esophageal acid exposure especially in the supine position has been documented in BE, as compared with the other gastroesophageal reflux disease phenotypes. In addition, weakly acidic reflu...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001358

    authors: Fass R,Teramoto O,Kurin M,Khalessi A,Kitayama Y,Shibli F

    更新日期:2020-07-01 00:00:00

  • Effects of lansoprazole on ethanol-induced injury and PG synthetic activity in rat gastric mucosa.

    abstract::Lansoprazole, a proton pump inhibitor, has been reported to inhibit ethanol-induced injury in rats. However, the mechanism of the protective effect is not known. This study was carried out to investigate the role of prostaglandin (PG) in the protective effect of lansoprazole. Male Wistar rats were given either 30 mg/k...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199506002-00003

    authors: Fukuda T,Arakawa T,Shimizu Y,Ohtani K,Higuchi K,Kobayashi K

    更新日期:1995-01-01 00:00:00

  • Comparison of transjugular intrahepatic portosystemic shunt (TIPS) alone versus TIPS combined with embolotherapy in advanced cirrhosis: a retrospective study.

    abstract:OBJECTIVE:This study was designed to determine whether a transjugular intrahepatic portosystemic shunt (TIPS) combined with embolotherapy was superior to TIPS alone. METHODS:Seventy-nine patients were included in the study (43 in the TIPS and embolotherapy group and 36 in the TIPS alone group). Embolotherapy was perfo...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318203dfb3

    authors: Xiao T,Chen L,Chen W,Xu B,Long Q,Li R,Li L,Peng Z,Fang D,Wang R

    更新日期:2011-08-01 00:00:00

  • Proximal pancreatectomy in the surgical management of chronic pancreatitis.

    abstract::During the past three decades, important advances in our understanding of the pathophysiology of chronic pancreatitis (CP), improved results of major pancreatic resections (including pancreatoduodenectomy), and integration of sophisticated diagnostic methods in clinical practice resulted in significant changes in our ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200201000-00014

    authors: Sakorafas GH,Tsiotou AG

    更新日期:2002-01-01 00:00:00

  • Psychotropic agents in irritable bowel syndrome.

    abstract::The use of antidepressants to treat patients with irritable bowel syndrome (IBS) has been extended in recent years because of their possible neuromodulatory and analgesic effects, generally in doses that do not have antidepressant effects. There seems to be sufficient evidence to support the recommendation that psycho...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200207001-00010

    authors: Wald A

    更新日期:2002-07-01 00:00:00

  • Efficacy of tacrolimus in the treatment of steroid refractory autoimmune hepatitis.

    abstract:BACKGROUND:Autoimmune hepatitis (AIH) is an immune mediated chronic liver disease with a prevalence of 17 cases/100,000. Resistance to the standard treatment of AIH (prednisone and azathioprine) occurs in 15% to 20%. There is currently no standard treatment of patients with steroid refractory AIH. GOALS:Determine the ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.mcg.0000139050.67178.be

    authors: Aqel BA,Machicao V,Rosser B,Satyanarayana R,Harnois DM,Dickson RC

    更新日期:2004-10-01 00:00:00

  • Cyclic vomiting associated with excessive dopamine in Riley-day syndrome.

    abstract:GOALS:To analyze the neurochemical profile during the recurrent attacks of nausea and vomiting in patients with Riley-day syndrome. BACKGROUND:One of the most disabling features of patients with Riley-day syndrome are recurrent attacks of severe nausea/retching/vomiting accompanied by hypertension, tachycardia, and sk...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e3182582cbf

    authors: Norcliffe-Kaufmann LJ,Axelrod FB,Kaufmann H

    更新日期:2013-02-01 00:00:00

  • Mucosal healing in inflammatory bowel disease.

    abstract::It is becoming increasingly recognized that purely clinical endpoints may not be sufficient in the treatment of patients with inflammatory bowel disease. As such, mucosal disease assessment has become a prominent component of the majority of recent clinical trials in Crohn's disease and ulcerative colitis. There is mo...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0b013e3182732ff5

    authors: Osterman MT

    更新日期:2013-03-01 00:00:00

  • Intestinal Failure: Adaptation, Rehabilitation, and Transplantation.

    abstract::Intestinal failure (IF) is a state in which the nutritional demands are not met by the gastrointestinal absorptive surface. A majority of IF cases are associated with short-bowel syndrome, which is a result of malabsorption after significant intestinal resection for numerous reasons, some of which include Crohn's dise...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0000000000000512

    authors: Bharadwaj S,Tandon P,Meka K,Rivas JM,Jevenn A,Kuo NT,Steiger E

    更新日期:2016-05-01 00:00:00

  • Antimitochondrial antibody-negative chronic nonsuppurative destructive cholangitis. Atypical primary biliary cirrhosis or autoimmune cholangitis?

    abstract::We investigated whether autoimmune cholangitis (AC) has specific features that constitute an entity other than primary biliary cirrhosis (PBC). We compared clinical, laboratory, and liver biopsy features; response to treatment; and the follow-up of two groups of patients. The first group comprised seven patients with ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199610000-00007

    authors: Sánchez-Pobre P,Castellano G,Colina F,Dominguez P,Rodriguez S,Canga F,Herruzo JA

    更新日期:1996-10-01 00:00:00

  • Treatment options for uncomplicated diverticular disease of the colon.

    abstract::Patients affected by uncomplicated diverticular disease (DD) suffer from colicky, unexplained, recurrent, and short-lived but often debilitating abdominal pain and alteration in bowel habit. Although the goals of therapy, such as to improve symptoms and to prevent both recurrent attacks and complications, are clearly ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0b013e3181b3ab2e

    authors: Rocco A,Compare D,Caruso F,Nardone G

    更新日期:2009-10-01 00:00:00

  • Management of sporadic duodenal adenomas and the association with colorectal neoplasms: a retrospective cohort study.

    abstract:GOALS:To evaluate management, outcome, and follow-up of patients with sporadic duodenal adenomas and assess the presence of colorectal neoplasms. BACKGROUND:With the widespread use of esophagogastroduodenoscopy, an increasing number of sporadic duodenal adenomas are diagnosed. An optimal algorithm for management has n...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318238e72d

    authors: van Heumen BW,Mul K,Nagtegaal ID,van Kouwen MC,Nagengast FM

    更新日期:2012-05-01 00:00:00

  • Association Between Helicobacter pylori Infection and Short-segment/Long-segment Barrett's Esophagus in a Japanese Population: A Large Cross-Sectional Study.

    abstract:GOAL:The goal of this study was to investigate the relationship between Helicobacter pylori (H. pylori) infection and short-segment and long-segment Barrett's esophagus (SSBE and LSBE). BACKGROUND:H. pylori infection is reported to be inversely associated with Barrett's esophagus (BE) in western countries. However, th...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001264

    authors: Usui G,Sato H,Shinozaki T,Jinno T,Fujibayashi K,Ishii K,Horiuchi H,Morikawa T,Gunji T,Matsuhashi N

    更新日期:2020-05-01 00:00:00

  • Hepatitis C virus RNA assays: a comparison of SuperQuant and Monitor.

    abstract::Hepatitis C RNA testing has been used extensively to assess the efficacy of antiviral therapy and has increasingly become an integral part of clinical management of patients with chronic hepatitis C. A variety of commercially available hepatitis C virus (HCV) RNA tests are used to detect HCV RNA qualitatively or quant...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200107000-00011

    authors: Hadziyannis E,Hadziyannis A,Yen-Lieberman B,Kiwi ML,Hodnick S,Spanou F,Starkey C,Younossi ZM

    更新日期:2001-07-01 00:00:00

  • Peritoneal mesothelioma in recurrent familial peritonitis.

    abstract::A 39-year-old man had a 2-year history of fatigue, weight loss, drug-resistant ascites, and decreased intestinal motility. During adolescence he began to suffer frequent episodes of acute benign peritonitis that spontaneously subsided at age 35. The fact that his younger brother was taking colchicine for the same symp...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199706000-00023

    authors: Gentiloni N,Febbraro S,Barone C,Lemmo G,Neri G,Zannoni G,Capelli A,Gasbarrini G

    更新日期:1997-06-01 00:00:00

  • Celecoxib Monotherapy Maintained Small Intestinal Mucosa Better Compared With Loxoprofen Plus Lansoprazole Treatment: A Double-blind, Randomized, Controlled Trial.

    abstract:GOALS:The aim of this study was to compare celecoxib with loxoprofen for protection of small intestine. BACKGROUND:RCT studies report that COX-2 selective inhibitor celecoxib induces fewer small intestinal injuries than nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Loxoprofen is a prodrug nonselective NS...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/MCG.0000000000000372

    authors: Fujimori S,Hanada R,Hayashida M,Sakurai T,Ikushima I,Sakamoto C

    更新日期:2016-03-01 00:00:00

  • Autoimmune pancreatitis, pancreatic mass, and lower gastrointestinal bleed.

    abstract::Autoimmune pancreatitis (AIMP) is a recently described clinical entity causing chronic pancreatitis. It often presents with diffuse enlargement of the pancreas and/or a focal mass at the head of the pancreas causing common bile duct obstruction and jaundice. In most instances, AIMP is mistaken for pancreatic cancer. A...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199906000-00019

    authors: Venu RP,Radke JS,Brown RD,Deutsch SF,Zaytsev PM,Miyaji E,Nishimori I

    更新日期:1999-06-01 00:00:00

  • Duodenal ulcer therapy with low-dose antacids: a multicenter trial.

    abstract::One hundred outpatients with endoscopically verified duodenal ulcer were treated in a double-blind, randomized, multicenter trial with either low-dose antacid (AA, Supralox, 1 tablet three times a day 1 h a.c. and 2 tablets at bedtime, with acid binding capacity of 225 mEq) or misoprostol (MS, Cytotec, 400 micrograms ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00004836-199112001-00025

    authors: Nauert C,Caspary WF

    更新日期:1991-01-01 00:00:00

  • Understanding and appreciating sequential therapy for Helicobacter pylori eradication.

    abstract::Despite the fact that sequential therapy has been evaluated in more than 2500 patients and has been shown to on average provide Helicobacter pylori eradication in 90% to 94%, some authorities still question whether it should be a first-line anti-H. pylori regimen. Here, we discuss H. pylori eradication using experienc...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31820ac05e

    authors: Graham DY,Rimbara E

    更新日期:2011-04-01 00:00:00

  • Intrasphincteric botulinum toxin versus pneumatic balloon dilation for treatment of primary achalasia.

    abstract:GOALS:Despite a high success rate, pneumatic dilatation for achalasia is accompanied by a significant risk of esophageal perforation. Injection of botulinum toxin (botox) into the lower esophageal sphincter (LES) can lead to improvement in symptoms with reduced risk of complications. Direct comparisons of the two techn...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004836-200303000-00005

    authors: Bansal R,Nostrant TT,Scheiman JM,Koshy S,Barnett JL,Elta GH,Chey WD

    更新日期:2003-03-01 00:00:00

  • Dysphagia and esophageal motor dysfunction in gastroesophageal reflux are corrected by fundoplication.

    abstract::Abnormalities in esophageal peristaltic function and acid clearance appear to be responsible for prolonged esophageal acid exposure, a major determinant of the reflux esophagitis and esophageal stricture. We evaluated esophageal motility by manometry in 50 healthy controls and in 35 symptomatic reflux patients before,...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199102000-00005

    authors: Grande L,Lacima G,Ros E,Pujol A,Garcia-Valdecasas JC,Fuster J,Visa J,Pera C

    更新日期:1991-02-01 00:00:00