Abstract:
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.
journal_name
Eur J Gastroenterol Hepatoljournal_title
European journal of gastroenterology & hepatologyauthors
Delwaide J,El Saouda R,Gérard C,Belaïche J,Groupe Liègeois d'Etude des Virus Hépatotropes.doi
10.1097/00042737-200511000-00006subject
Has Abstractpub_date
2005-11-01 00:00:00pages
1185-9issue
11eissn
0954-691Xissn
1473-5687pii
00042737-200511000-00006journal_volume
17pub_type
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