January 6, 2013

Few hepatitis C patients receive complete treatment

Published on December 31, 2012 at 5:15 PM

By Lauretta Ihonor, medwireNews reporter

Less than 10% of patients with hepatitis C (HCV) receive the treatment they need to achieve a sustained virologic response (SVR), results from a systematic review show.

The review, which included 25 studies conducted in the US, Canada, and Australia, revealed that 19% of HCV-infected and 16% of HCV/HIV-coinfected patients are considered eligible for treatment.

And only 3% and 6% of HCV-infected and HCV/HIV-coinfected patients, respectively, continue with treatment until a SVR is achieved, say the authors in General Hospital Psychiatry.

The authors highlight that recently developed direct-acting antivirals are very effective at curing HCV when used in combination with pegylated interferon and ribavirin.

But the side effects associated with these drugs are greater than those of traditional antiviral therapy and this may deter patients from seeking treatment, add Carol North (The University of Texas Southwestern Medical Center, Dallas, USA) and team.

They therefore recommend that researchers and physicians address such treatment concerns "so that the benefits of emerging scientific achievements can be realized in the care of HCV in the community."

The review identified four barriers to receipt of care: medical ineligibility, patient-related barriers, provider-related barriers, and medical care system barriers.

Medical and psychosocial problems, such as substance misuse, psychiatric illness, and medical comorbidity, were found to hinder receipt of treatment in up to one third of HCV patients.

"Management of these problems in patients with psychiatric and/or substance-use problems has the potential to improve their treatment readiness and likelihood of successfully completing HCV treatment," say North et al.

Only studies performed in real-life, non-clinical trial settings were included in the systematic review to ensure that a true impression of "real-world" HCV treatment practices was obtained.

In all studies, patient flow through the HCV care pathway was recorded in terms of the percentage of HCV patients presenting for care who were deemed eligible for treatment, started treatment, completed treatment, and achieved a SVR.

North and colleagues conclude that the findings from the current review illustrate that new interventions are required to encourage HCV patients to "engage in treatment and achieve success in completing treatment."

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