Majority of patients with hepatitis C express physical, mental, and social difficulties with antiviral treatment.
OBJECTIVE
The hepatitis C virus can be successfully treated in up to 60% of infected patients. However, treatment is long and is associated with significant side-effects. We investigated difficulties with this treatment as it is an important factor in patient adherence.


METHODS
Patients receiving hepatitis C treatment in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status, and co-morbidities were collected from patients or abstracted from the medical records. All participants underwent a semistructured interview, which was analysed by blinded coders.


RESULTS
A total of 65 patients (mean age 46.1 years; 38.5% women) were enrolled. Fifty-two (80%) described moderate to severe problems attributed to treatment, with a predominance of physical difficulties (fatigue 74% of cases; flu-like symptoms 32%). Approximately one third of patients (38%) experienced depression during treatment. In 31% of cases, physical or emotional problems forced patients to quit their jobs or reduce employment. One fifth attributed deteriorating relationships with friends and family to adverse treatment effects. Necessary lifestyle adjustments, such as alcohol abstinence, caused frictions with friends in 22% of the participants.


CONCLUSIONS
Our findings show a high prevalence of significant adverse effects in patients undergoing antiviral therapy. Whereas the nature and severity of these adverse reactions is consistent with earlier reports, we identified implications with worsening private and professional relationships. To encourage appropriate levels of adherence, healthcare providers should seek information about these indirect treatment effects as they monitor their patients on therapy.
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. susan.zickmund@med.va.gov
Susan L
SL
Zickmund
Cindy L
CL
Bryce
Julie A
JA
Blasiole
Laura
L
Shinkunas
Douglas R
DR
LaBrecque
Robert M
RM
Arnold
D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D000998:Antiviral Agents / Q000009:adverse effects*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010349:Patient Compliance; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology
D000998:Antiviral Agents