Comparison of characteristics of treated and non-treated patients with Hepatitis C infection.
OBJECTIVE
This study compares the characteristics of treated and non-treated patients with Hepatitis C (HCV) infection.


METHODS
Information on patient demographics, clinical data, and treatment regimens were collected from a retrospective medical record review of 998 patients diagnosed with HCV, representing a diverse geographic sample of 200 U.S. physicians including 130 gastroenterologists, 50 infectious disease physicians, and 20 hepatologists. A total of 551 patients were randomly selected and 447 were provided as an augmented sample in an intent-to-treat analysis based on treatment decisions. Pretreatment factors examined included age, gender, race, weight, HCV genotype, HCV viral load, serum ALT levels, liver biopsy results, cirrhosis, HIV co-infection, HBV co-infection, IV drug use, and insurance status. Univariate analyses were performed using Chi-squared or ANOVA tests. Factors that were significant in univariate analyses were entered into a multivariate logistic regression model with HCV treatment as the outcome variable.


RESULTS
Of the 998 patients reviewed, 778 were treated for HCV and 220 were not treated. In univariate analyses, non-treated patients were more likely to be African American, HBV co-infected, HIV co-infected, IDUs, alcoholics, Medicaid insured, and were less likely to have had biopsies. The multivariate regression analysis demonstrated that performance of a liver biopsy, treatment with psychiatric medications (antidepressants and anxiolytics), and patient weight were independently associated with treatment, while Medicaid insurance and HIV co-infection were independently associated with a decreased likelihood of receiving HCV therapy.


CONCLUSIONS
This study suggests that it is not the clinical stage of HCV infection but the patient's demographic characteristics and co-morbid conditions that impact the decision to initiate HCV therapy.
Hare
C Bradley
CB
University of California, San Francisco, Positive Health Program, SFGH, 3180 18th Street, Suite 305, San Francisco, CA 94110, USA. chare@php.ucsf.edu
Morris
Jonathan A
JA
Chu
Alice
A
Gotz
Vincent
V
Loveland
Jacqueline J
JJ
Hodes
David
D
Klaskala
Winslow
W
D000328:Adult; D000554:Ambulatory Care Facilities; D000998:Antiviral Agents / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008484:Medicaid; D008499:Medical Records; D008875:Middle Aged; D010349:Patient Compliance; D018579:Patient Selection; D012189:Retrospective Studies; D012959:Socioeconomic Factors
D000998:Antiviral Agents; D007372:Interferons