A team from Cleveland, Ohio, USA, determined the applicability and usefulness of interferon-based antiviral therapy in a metropolitan clinic population of persons with hepatitis C virus (HCV) infection.
A total of 327 patients, referred to the liver clinic after a positive result for antibody against HCV on enzyme-linked immunosorbent assay, were included in the study.
Treatment rates, and reasons for non-treatment, were noted.
Some 34 patients had no detectable HCV RNA.
| Only 23% of patients with HCV were treated with antiviral therapy.
| Annals of Internal Medicine |
Of the remaining 293 patients, 72% were not treated for several reasons.
The reasons were as follows: 37% did not adhere to evaluation procedures, 34% had medical or psychiatric contraindications, and 13% had ongoing substance or alcohol abuse.
In addition, 11% preferred no treatment, and 5% had normal liver enzyme levels.
Only 83 patients (28%) were treated. The researchers found that, of these, 13% had a sustained viral response.
Dr Yngve Falck-Ytter, of the MetroHealth Medical Center and Case Western Reserve University, Cleveland, concluded on behalf of fellow authors, "Most patients with HCV infection are not candidates for interferon-based therapies.
"Alternative interventions should be sought for these patients."