April 18, 2013

HCV-infected patients bury heads in sand

By Kirsty Oswald, medwireNews Reporter

08 April 2013

J Viral Hepat 2013; Advance online publication

medwireNews: Researchers have found poor levels of knowledge about hepatitis C virus (HCV) among individuals with HCV mono-infection and HCV/HIV co-infection.

Patients who were indifferent to the need for treatment or reported feeling ashamed of their HCV-positive status scored particularly badly in knowledge tests.

Mamta Jain (University of Texas Southwestern Medical Center, Dallas, USA) and colleagues found that both mono- and co-infected patients scored under 50% in a knowledge test, which assessed understanding of HCV disease, transmission, and treatment.

Among 292 respondents recruited through outpatient clinics, many reported fear about their infection, with 56.8% acknowledging that they were scared about their HCV status, and 31.7% feeling stigmatized by it.

Worryingly, 18.0% thought that HCV does not cause health problems, 15.2% thought that they do not require treatment due to lack of symptoms, and 20.7% said feeling ashamed prevented them from seeking treatment.

Knowledge scores were significantly lower among the 26.6% of patients who thought medication was unnecessary for HCV, than for those who did not endorse this belief, at a mean of 15.1 vs 17.5 out of 34, with a similar gap in knowledge between those who did and did not say they felt ashamed about HCV (15.3 vs 17.2).

While knowledge levels were comparable between mono- and co-infected patients, co-infected participants had more knowledge about HCV treatment and about HIV, and perceived less stigma from HCV. The authors suggest this may be due to their ongoing HIV care, and that these patients may perceive their HIV-positive status as more stigmatizing than HCV.

Additionally, 87 patients took an abridged version of the survey before and after a 1-hour education session designed to improve knowledge and attitudes regarding HCV. The authors found that while this did not lead to changes in the respondents' attitudes, it did increase their mean knowledge score from a mean of 17.2 to 23.3 points out of 34.

"However, re-education and ongoing support may be necessary to maintain patients' knowledge level about HCV," say Jain and colleagues, writing in the Journal of Viral Hepatitis.

"There also remains a need to develop interventions that could specifically modify attitudes towards HCV treatment," they add.

Despite effective treatments, which can lead to high rates of sustained virological response, many mono-and co-infected HCV patients fail to get treatment, the authors explain.

"Future studies are needed to effectively change attitudes and determine whether those changes will affect health behaviour among mono-infected and co-infected populations," they conclude.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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