A team from Missouri, USA, investigated the success of hepatitis C virus (HCV) antiviral therapy in United States veterans.
They retrospectively examined clinic show rates, treatment eligibility, and the response to antiviral therapy in a dedicated HCV outpatient clinic in a large urban Veterans Affairs medical center.
The data demonstrated that few veterans - regardless of their age or ethnic background - pursue evaluation and treatment of their HCV infection by hepatologists.
A minority of patients who do undergo a comprehensive clinic evaluation meet the standard eligibility criteria for antiviral therapy.
| HCV-infected veterans characterized by risk factors predictive of poor therapy response.
| American Journal of Gastroenterology |
The researchers found that the overall efficacy of antiviral treatment, as measured by the sustained virological response rate, is substantially lower than previously reported in randomized clinical trials.
HCV-infected veterans are characterized by a unique combination of risk factors that are predictive of a poor response to antiviral therapy. These include a preponderance of male gender, HCV genotype I, age greater than 40 years, and histologically advanced degrees of liver disease.
Author C. H. Cawthorne, of the St. Louis VA Medical Center, Missouri, concluded on behalf of the group, "Our study demonstrates the limitations of outpatient HCV treatment initiatives in the United States veteran population.
"It also suggests that the overall impact of current HCV treatment programs may be small."