Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Reasons why Hep C patients choose to defer treatment

A significant proportion of patients infected with Hepatitis C opt to defer treatment, and most are genotype 1, reports the latest issue of Digestive Diseases and Sciences.

News image

fiogf49gjkf04

Drs Omar Khokhar and James Lewis from Washington DC determined the percentage of treatment-naïve patients infected with chronic Hepatitis C virus.

The patients made an informed choice to defer treatment with pegylated interferon regimens in the absence of any medical, psychosocial, or other contraindications.

The investigative team reassessed the patients' decision by using a questionnaire at least 1 year later.

The team retrieved patient charts dating from 2001.

The investigators retrospectively analyzed patient age, gender, race, Hepatitis C viral load, genotype, and liver biopsy results.

The team also evaluated hepatic imaging results, and peak alanine aminotransferase levels.

Comorbid conditions, source of infection, and estimated duration of infection were assessed.

In addition, the team determined reasons given by the patient for declining pegylated interferon-based treatment at the time of their consultation.

The team used a questionnaire survey to determine the patients' satisfaction with their initial decision.

41% otherwise eligible for therapy opted to defer
Digestive Diseases and Sciences

Of 446 patient charts reviewed, 280 patients were treatment-naïve, and were judged to have no contraindications to receiving interferon-based therapy.

Of these, 115 opted to defer treatment, and are the subject of this analysis.

The team found women declining therapy outnumbered men by approximately 3 to 2.

Middle-aged patients were most likely to choose expectant therapy compared with older or younger individuals.

The team found that the 48% of African American patients who deferred therapy vs 37% of non-African American patients.

More than 90% of the patients choosing to be followed were genotype 1.

The team noted that peak alanine aminotransferase values were normal in 37%, and less than 2 times the upper limits of normal in another 40%.

The estimated duration of chronic Hepatitis C infection was over 16 years in approximately 75% of individuals.

The investigators found that the most common source of the patients' infection was intravenous drug use followed by transfusion-related.

The most common reason for opting not to receive treatment was the asymptomatic nature of their infection.

The team noted that this concern was coupled with the patient's concern about side effects of the medications.

Approximately 10% had unfavorable social situations, including a lack of support or health insurance.

Only 4% of patients cited doubts about efficacy as the main reason that they did not want to be treated.

The team found after 1 year that 79% of the patients confirmed their ongoing satisfaction with their initial decision to decline treatment.

Another 11% of patients indicated that they were still ‘moderately satisfied' with their decision, and unlikely to change it in the near-future.

The investigators noted that only 7% of patients voiced their current dissatisfaction with expectant management.

These patients expressed the desire to have a follow-up discussion about treatment options.

The remaining 4% of patients already started treatment or were deceased of non-liver-related causes.

The investigators found that 41% of patients infected with Hepatitis C virus who are otherwise eligible for therapy opted to defer treatment.

Dr Omar Khokhar and colleague concluded, “A significant proportion of patients infected with Hepatitis C opt to defer treatment.”

“African American patients defer in a higher proportion than non-African American patients.”

“Nearly all of our patients were genotype 1 with clinically and histologically mild hepatitis of reasonably long duration.”

“Our questionnaire survey found that most remained satisfied with their decision to defer treatment at the present time.”

“Few patients cited a perceived low rate of efficacy of pegylated interferon and ribavirin therapy as the principal reason that they chose not to initiate treatment.”

Dig Dis Sci 2007: 52(5): 1168-76
23 April 2007

Go to top of page Email this page Email this page to a colleague

 24 May 2018 
Precision medicine for tumors
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 23 May 2018 
High body mass index is and ulcerative colitis
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Fecal incontinence and quality of life in IBD
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Depressive symptoms in IBD youth
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
New therapies for CDI
 15 May 2018 
Hep B in the Grey Zone
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Esophageal dilatation in clinical practice 
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's
 24 April 2018 
Microbiome in athletes vs sedentary subjects
 23 April 2018 
Genome-wide study on HBV-related acute-on-chronic liver failure

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us