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Contraindications to pegylated-interferon or ribavirin in HCV patients in the USA

A study published ahead of print in Alimentary Pharmacology & Therapeutics reports on contraindications to pegylated-interferon or ribavirin in the US general patient population with chronic Hepatitis C.

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Chronic Hepatitis C treatment with pegylated-interferon ribavirin is often limited by preexisting medical, psychiatric and psychosocial contraindications.

However, limited data exist in general patient populations.

Dr Talal and colleagues from New York, USA evaluated the percentage of chronic Hepatitis C-infected patients in the general US population who may have contraindications to pegylated-interferon.

The General Electric Centricity dataset was used to screen the US population between 2004 and 2009 for chronic Hepatitis C infection and contraindications to  pegylated-interferon.

Chronic Hepatitis C diagnosis and contraindications were identified using ICD-9-CM codes or laboratory values.

The researchers reported that only patients with an encounter 180 days prior to chronic Hepatitis C diagnosis were included.

The team of doctors determined frequencies and percentages for absolute and relative contraindications to pegylated-interferon and/or ribavirin, and calculated proportions and rates per 1000 person-months.

17% had at least one contraindication to pegylated-interferon
Alimentary Pharmacology & Therapeutics

A total of 15,561,021 patients were screened, and 45,690 who were chronic Hepatitis C-positive were evaluated.

The research team observed that those with contraindications were significantly younger, female, White, not currently married and receiving Medicare or Medicaid coverage.

The team observed that 17% had at least one contraindication to pegylated-interferon, including bipolar disorder, anemia, pregnancy, and neutropenia.

Dr Talal's team concludes, "Approximately, 17% of chronic Hepatitis C-infected patients in the general US population had at least one contraindication to pegylated-interferon."

"Most contraindications were relative and potentially modifiable."

"Clinical assessment of contraindications as relative and/or modifiable should be considered and used to determine if patients could benefit from current pegylated-interferon–containing triple therapy or future pegylated-interferon– or ribavirin-free regimens."

Aliment Pharmacol Ther 2013: 37(4): 473–481
24 January 2013

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