title: Surprisingly small effect of antiviral treatment in patients with hepatitis C.
abstract: 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.
authors.affiliation: German Cochrane Institute, Stefan-Meier-Strasse 26, 79104 Freiburg, Germany.
authors.forename: Yngve
authors.initials: Y
authors.lastname: Falck-Ytter
authors.forename: Hemangi
authors.initials: H
authors.lastname: Kale
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Mullen
authors.forename: Steedman A
authors.initials: SA
authors.lastname: Sarbah
authors.forename: Lucian
authors.initials: L
authors.lastname: Sorescu
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: McCullough
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons