Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection

Details

• Alternative Title:
  Int J Circumpolar Health
• Personal Author:
  Livingston, Stephen E ; Townshend-Bulson, Lisa J ; Bruden, Dana L ; McMahon, Brian J ; Homan, Chriss E ; Gove, James E ; Deubner, Heike ; Bruce, Michael G ; Robinson, Renee F ; Gretch, David R
• Description:
  Objectives
  
  Treatment with pegylated interferon and ribavirin may prevent progression of liver disease among patients with chronic hepatitis C virus infection (HCV) Treatment initiation is based on published clinical eligibility criteria, patients’ willingness to undergo treatment and likelihood of success We examined treatment eligibility in a cohort of Alaska Native and American Indian persons with chronic HCV infection
  
  Study design
  
  Retrospective cohort study
  
  Methods
  
  Medical records of all treatment naïve HCV RNA positive patients given an appointment by hepatology specialty clinic staff in 2003 and 2007 were evaluated by a hepatology provider to investigate documented reasons for treatment deferral
  
  Results
  
  Treatment was initiated in 4 of 94 patients (4%) in 2003 and 14 of 146 patients (10%) in 2007 Major reasons for treatment deferral in 2003 versus 2007 included inconsistent appointment attendance (36% of deferrals vs 18%), active substance abuse (17% vs 22%), patient decision (17% vs 27%), liver biopsy without fibrosis or normal ALT (8% vs 3%), uncontrolled psychiatric condition (7% vs 7%) and concurrent medical condition (6% vs 9%) There was significant improvement in proportion of appointments attended in 2007 versus 2003 (76% vs 67%, p =004) and the percentage of patients attending at least 1 appointment (84% vs 66%, p=0002)
  
  Conclusions
  
  Multiple reasons for treatment deferral were documented Despite a significant improvement in hepatology clinic attendance and an increase in the number of patients started on treatment in 2007 compared to 2003, the overall percentage of those treated remained low
  
  
• Subjects:
  Adult Alaska Natives Antiviral Agents Cohort Studies Drug Therapy, Combination Eligibility Determination Female Hepatitis C Humans Indians, North American Interferons Male Middle Aged Retrospective Studies Ribavirin

  More +
• Source:
  Int J Circumpolar Health 2012; 71
• Document Type:
  Journal Article
• Place as Subject:
  Alaska
• Location:
  Alaska
• Volume:
  71
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:56ee0fa4c701584a382f075bc2edd20ea859329712eaaa72b8c8cdf6ece330c7
• Download URL:
  https://stacks.cdc.gov/view/cdc/10911/cdc_10911_DS1.pdf
• File Type:
  [PDF - 240.60 KB ]