title: Collaboration between Hepatologists and Primary Care Physicians in Treating Patients with Chronic Hepatitis C.
abstract: OBJECTIVE
  The purpose of this study was to assess the treatment outcome in patients with chronic hepatitis C (CHC) using the current standard antiviral therapy when patient were treated in collaboration between hepatologists and primary care physicians (PCPs).
  
  
  METHODS
  One hundred and ten patients with CHC were treated with a combination therapy of peginterferon-alpha 2b and ribavirin. Among them, 25 patients were treated by a collaboration between hepatologists and PCPs (collaboration group), whereas 85 patients were treated with exclusively by hepatologists (noncollaboration group). The duration of the therapy was 48 weeks for 58 'difficult- to-treat' patients (genotype 1 with a high load of HCV-RNA; 1H patients) and 24 weeks for the remaining 52 patients (non-1H patients). In the collaboration group, antiviral therapy was initiated and adjusted, if needed, by hepatologists (visits every four weeks), whereas the weekly administration of peginterferon-alpha 2b was performed by PCPs. Clinical characteristics and the treatment outcome were compared between these two groups.
  
  
  RESULTS
  The two groups had similar baseline characteristics. By intention to treat, the two groups showed similar rates of treatment-related serious adverse effects (0% vs. 1%, respectively) and dropout rates for adverse effects (8% vs. 13%, respectively). Sustained virologic response rates were also similar between the two groups, being 42% vs. 39% in the 58 1H patients (NS) and 62% vs. 64% in the 52 non-1H patients (NS), respectively.
  
  
  CONCLUSIONS
  Collaboration between hepatologists and PCPs may be a valid treatment alternative to treat patients with CHC using the current standard antiviral therapy.
authors: Division of Gastrointestinal Diseases, Tsuchiura Kyodo General Hospital, Japan.
authors: Junichi
authors: J
authors: Tazawa
authors: Division of Gastrointestinal Diseases, Tsuchiura Kyodo General Hospital, Japan.
authors: Yoshinori
authors: Y
authors: Sakai
authors: Division of Gastrointestinal Diseases, Tsuchiura Kyodo General Hospital, Japan.
authors: Fumihiko
authors: F
authors: Kusano
authors: Division of Gastrointestinal Diseases, Tsuchiura Kyodo General Hospital, Japan.
authors: Kazuyoshi
authors: K
authors: Nagayama
authors: Division of Internal Medicine, Tsuchiura Kyodo General Hospital, Japan.
authors: Hideomi
authors: H
authors: Fujiwara
keywords: chronic hepatitis C; collaboration; peginterferon; primary care physician; ribavirin
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