Surprisingly small effect of antiviral treatment in patients with hepatitis C.
BACKGROUND
The effect and applicability of interferon-based antiviral therapies in the general population of persons with hepatitis C virus (HCV) infection are unknown.


OBJECTIVE
To determine the applicability and usefulness of anti-viral therapy in a metropolitan clinic population.


METHODS
Retrospective case series of consecutively referred patients.


METHODS
A teaching county hospital in Cleveland, Ohio.


METHODS
327 patients referred to a liver clinic after a positive result for antibody against HCV on enzyme-linked immunosorbent assay (ELISA).


METHODS
Treatment rates; reasons for nontreatment.


RESULTS
34 patients had no detectable HCV RNA. Of the remaining 293 patients, 72% were not treated for the following reasons: 37% did not adhere to evaluation procedures, 34% had medical or psychiatric contraindications, 13% had ongoing substance or alcohol abuse, 11% preferred no treatment, and 5% had normal liver enzyme levels. Only 83 patients (28%) were treated; 13% had a sustained viral response.


CONCLUSIONS
Most patients with HCV infection are not candidates for interferon-based therapies; alternative interventions should be sought for these patients.
Falck-Ytter
Yngve
Y
German Cochrane Institute, Stefan-Meier-Strasse 26, 79104 Freiburg, Germany.
Kale
Hemangi
H
Mullen
Kevin D
KD
Sarbah
Steedman A
SA
Sorescu
Lucian
L
McCullough
Arthur J
AJ
D000998:Antiviral Agents / Q000627:therapeutic use*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D016312:Treatment Refusal
D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons