Τίτλος:
Frequency and predictors of no treatment in anti-hepatitis C
virus-positive patients at tertiary liver centers in Greece
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background/aims Despite the improving efficacy of antiviral therapy, a
significant proportion of chronic hepatitis C patients never start
treatment. We determined the magnitude and reasons for no treatment in
anti-hepatitis C virus (HCV)-positive patients visiting tertiary liver
centers in Greece.
Materials and methods We retrospectively enrolled 1146 consecutive
anti-HCV-positive patients who visited four physicians at two tertiary
liver centers between 2002 and 2010.
Results Treatment was initiated in 628 (55%) of the 1146 patients. In
particular, 309 (27%) patients were lost to follow-up before HCV RNA
testing. Independent predictors of no HCV RNA testing were first visit
before 2007, parenteral drug use, and the treating physician. Of the 837
patients tested for HCV RNA, 768 (92%) were eligible for antiviral
therapy, had detectable serum HCV RNA, and no contraindication to
treatment. Among them, 140 (18%) patients were lost to follow-up before
the initiation of treatment or refused antiviral therapy. Independent
predictors of no treatment were the treating physician, absence of liver
biopsy or transient elastography (odds ratio: 3.5, 95% confidence
interval: 2.3-5.4, P < 0.001), and normal compared with elevated alanine
transaminase levels (odds ratio: 1.7, 95% confidence interval: 1.1-2.8,
P = 0.027).
Conclusion A significant proportion (>40%) of anti-HCV-positive
patients visiting Greek tertiary liver centers do not receive antiviral
therapy. Most of them are lost during the initial evaluation process,
whereas the majority (>80%) of eligible patients who complete the
initial evaluation eventually start antiviral therapy. The probability
of treatment seems to be significantly associated with the treating
physician, the alanine transaminase levels, and whether liver biopsy or
transient elastography was performed. Eur J Gastroenterol Hepatol
25:587-593 (C) 2013 Wolters Kluwer Health vertical bar Lippincott
Williams & Wilkins.
Συγγραφείς:
Papadopoulos, Nikolaos
Manolakopoulos, Spilios
Deutsch, Melanie
and Mela, Maria
Christidou, Aggeliki
Katoglou, Athina and
Tzourmakliotis, Dimitrios
Papatheodoridis, George V.
Περιοδικό:
European Journal of Gastroenterology and Hepatology
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
barrier; chronic hepatitis C; pegylated interferon-alpha
DOI:
10.1097/MEG.0b013e32835cb5c0
