June 24, 2013

Adherence to, initiation of HBV therapy prove problematic in real-world settings

Provided by Healio

June 24, 2013

ORLANDO, Fla. — Mindie H. Nguyen, MD, MAS, associate professor of medicine at Stanford University School of Medicine, discusses two of her studies presented at Digestive Disease Week.

In one study, “Effectiveness of Oral Antiviral Therapy for Treatment-Naive Chronic Hepatitis B (CHB) in Routine Clinical Practice,” Nguyen and colleagues evaluated the effectiveness of four oral therapies for HBV in a large, real world-cohort. They found that first-line agents tenofovir and entecavir were more effective than older medications lamivudine and adefovir. Nguyen said medical nonadherence can be a larger issue than antiviral resistance, and that many factors beyond patient noncompliance can contribute to this problem and lead to virologic breakthrough.

In a second study, “Antiviral Treatment Eligibility and Treatment Rates in Patients With Chronic Hepatitis B (CHB) At Primary Care, Community and University Referral Clinics: a Comparative Study,” the researchers evaluated treatment eligibility rates among HBV patients in various settings. Patients in tertiary clinics had greater HBV DNA and ALT levels and higher eligibility rates than those observed at other clinics. Nguyen points out, however, only 60% to 70% of patients meeting eligibility criteria at the evaluated community GI and tertiary clinics initiated therapy within 1 year of evaluation. Lower rates were observed among patients treated at primary care clinics.

Nguyen cites several factors, such as a patient’s unwillingness to start treatment while asymptomatic, can delay treatment initiation, and calls for improved education for patients and physicians.


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