title: Nationwide survey of specialist knowledge on current standard of care (Peg-IFN/RBV) and barriers of care in chronic hepatitis C patients in China.
abstract: OBJECTIVE
  Chronic hepatitis C virus (HCV) infection is the leading cause of liver diseases including cirrhosis and hepatocellular carcinoma. In China, it is a major national health problem that demands nationwide coordinated emphasis on prevention and treatment. To inform these initiatives, a nationwide survey was conducted from January to April 2015 to evaluate the knowledge, awareness, and perceived obstacles to HCV care.
  
  
  METHODS
  A sample of 1000 HCV specialists across mainland China were recruited. Respondents were asked a series of 30 open-ended single or multiple response and Likert-scale questions about their HCV treatment knowledge, experience, assessment of HCV care status in China, and perceptions about treatment barriers.
  
  
  RESULTS
  Sixty percent of the respondents answered incorrectly to more than half of the questions on basic HCV treatment principles. Over half of them incorrectly believed that maintenance therapy should be prescribed for non-responders (72%) and longer treatment duration improved sustained viral response rates (62%), regardless of HCV RNA level changes. Sixty-six percent of them believed that HCV treatment would still be interferon-based therapy in the next 5 years in China. Patient-related barriers, in particular lack of disease awareness, were considered to be the most significant barriers to HCV care. Payer and medical-provider barriers included affordability issues, lack of reimbursement coverage for testing and treatments, and lack of referral to HCV specialists.
  
  
  CONCLUSIONS
  Focused and intense patient and provider education should be carried out to increase awareness. More effective direct-acting antivirals should be made available and affordable in China.
authors.affiliation: Peking University People's Hospital, Peking University Hepatology Institute.
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.affiliation: School of Basic Medical Sciences, Peking University Health Science Center.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Chinese Foundation for Hepatitis Prevention and Control.
authors.forename: Xizhong
authors.initials: X
authors.lastname: Yang
authors.affiliation: Peking University First Hospital.
authors.forename: Guiqiang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Hepatology Institute.
authors.forename: Bo
authors.initials: B
authors.lastname: Feng
authors.affiliation: Southern Medical University Nanfang Hospital.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Hou
authors.affiliation: Beijing You'An Hospital Affiliated to the Capital Medical University.
authors.forename: Zhongping
authors.initials: Z
authors.lastname: Duan
authors.affiliation: Beijing Friendship Hospital Affiliated to the Capital Medical University.
authors.forename: Jidong
authors.initials: J
authors.lastname: Jia
authors.affiliation: The Second Affiliated Hospital of Chongqing Medical University.
authors.forename: Hong
authors.initials: H
authors.lastname: Ren
authors.affiliation: The First Hospital of Jilin University.
authors.forename: Junqi
authors.initials: J
authors.lastname: Niu
authors.affiliation: Beijing You'An Hospital Affiliated to the Capital Medical University.
authors.forename: Xinyue
authors.initials: X
authors.lastname: Chen
authors.affiliation: Beijing 302 Hospital.
authors.forename: Fu-Sheng
authors.initials: FS
authors.lastname: Wang
authors.affiliation: Henan Province People's Hospital.
authors.forename: Jia
authors.initials: J
authors.lastname: Shang
authors.affiliation: Bristol-Myers Squibb.
authors.forename: Qingyan
authors.initials: Q
authors.lastname: Bo
authors.affiliation: Bristol-Myers Squibb.
authors.forename: Runqin
authors.initials: R
authors.lastname: Li
authors.affiliation: IMS Health China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: School of Basic Medical Sciences, Peking University Health Science Center.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D002681:China; D002983:Clinical Competence; D004359:Drug Therapy, Combination; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use*; D010353:Patient Education as Topic; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D059039:Standard of Care; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D011092:Polyethylene Glycols; D012254:Ribavirin; D007372:Interferons
keywords: China; barriers to care; direct-acting antivirals; hepatitis C virus