Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection

Warren N SCHMIDT; Edmund J BINI; Norbert BRÄU; Paul KING; Ramsey CHEUNG; Timothy R MORGAN; Joseph AWAD; Marcos PEDROSA; Kyong-Mi CHANG; Ayse AYTAMAN; Franz SIMON; Curt HAGEDORN; Richard MOSELEY; Sue CURRIE; Jawad AHMAD; Charles MENDENHALL; Bradford WATERS; Doris STRADER; Anna W SASAKI; Stephen ROSSI; Teresa L WRIGHT; HUI SHEN; Bhupinderjit S ANAND; Ke-Qin HU; Lennox JEFFERS; Samuel B HO; David JOHNSON

doi:10.1111/j.1572-0241.2005.41860.x

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Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection

Journal article

Peer reviewed

Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection

Warren N SCHMIDT, Edmund J BINI, Norbert BRÄU, Paul KING, Ramsey CHEUNG, Timothy R MORGAN, Joseph AWAD, Marcos PEDROSA, Kyong-Mi CHANG, Ayse AYTAMAN, …

The American journal of gastroenterology, Vol.100(8), pp.1772-1779

2005

DOI: 10.1111/j.1572-0241.2005.41860.x

PMID: 16086714

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Abstract

BACKGROUND: Many veterans may not be candidates for hepatitis C virus (HCV) treatment due to contraindications to therapy. The aims of this study were to determine the proportion of HCV-infected veterans who were eligible for interferon alfa and ribavirin therapy and to evaluate barriers to HCV treatment. METHODS: We prospectively enrolled 4,084 veterans who were referred for HCV treatment over a 1-yr period at 24 Veterans Affairs (VA) Medical Centers. Treatment candidacy was assessed using standardized criteria and the opinion of the treating clinician. RESULTS: Overall, 32.2% (95% CI, 30.8-33.7%) were candidates for HCV treatment according to standardized criteria, whereas 40.7% (95% CI, 39.2-42.3%) were candidates in the opinion of the treating clinician. Multivariable analysis identified ongoing substance abuse (OR = 17.68; 95% CI, 12.24-25.53), comorbid medical disease (OR = 9.62; 95% CI, 6.85-13.50), psychiatric disease (OR = 9.45; 95% CI, 6.70-13.32), and advanced liver disease (OR = 8.43; 95% CI, 4.42-16.06) as the strongest predictors of not being a treatment candidate. Among patients who were considered treatment candidates, 76.2% (95% CI, 74.0-78.3%) agreed to be treated and multivariable analysis showed that persons ≥50 yr of age (OR = 1.37; 95% CI, 1.07-1.76) and those with >50 lifetime sexual partners (OR = 1.44; 95% CI, 1.08-1.93) were more likely to decline treatment. CONCLUSIONS: The majority of veteran patients are not suitable candidates for HCV treatment because of substance abuse, psychiatric disease, and comorbid medical disease, and many who are candidates decline therapy. Multidisciplinary collaboration is needed to overcome barriers to HCV therapy in this population

Infectious Diseases

Antiviral agents

Viral hepatitis

Pharmacology. Drug treatments

Viral diseases

Biological and medical sciences

Medical sciences

Human viral diseases

Antibiotics. Antiinfectious agents. Antiparasitic agents

Details

Title: Subtitle: Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection
Creators: Warren N SCHMIDT - VA Medical Center, Iowa City, Iowa, United States
Edmund J BINI - VA New York Harbor Healthcare System and NYU School of Medicine, New York, New York, United States
Norbert BRÄU - VA Medical Center, Bronx, New York, United States
Paul KING - VA Medical Center, Columbia, Missouri, United States
Ramsey CHEUNG - VA Medical Center, Palo Alto, California, United States
Timothy R MORGAN - VA Medical Center, Long Beach, California, United States
Joseph AWAD - VA Medical Center, Nashville, Tennessee, United States
Marcos PEDROSA - VA Medical Center, Boston, Massachusetts, United States
Kyong-Mi CHANG - VA Medical Center, Philadelphia, Pennsylvania, United States
Ayse AYTAMAN - VA Medical Center, Brooklyn, New York, United States
Franz SIMON - VA Medical Center, Denver, Colorado, United States
Curt HAGEDORN - VA Medical Center, Atlanta, Georgia, United States
Richard MOSELEY - VA Medical Center, Ann Arbor, Michigan, United States
Sue CURRIE - VA Medical Center, San Francisco, California, United States
Jawad AHMAD - VA Medical Center, Pittsburgh, Pennsylvania, United States
Charles MENDENHALL - VA Medical Center, Cincinnati, Ohio, United States
Bradford WATERS - VA Medical Center, Memphis, Tennessee, United States
Doris STRADER - VA Medical Center, Washington, District of Columbia, United States
Anna W SASAKI - VA Medical Center, Portland, Oregon, United States
Stephen ROSSI - VA Medical Center, San Francisco, California, United States
Teresa L WRIGHT - VA Medical Center, San Francisco, California, United States
HUI SHEN - VA Medical Center, Bronx, New York, United States
Bhupinderjit S ANAND - VA Medical Center, Houston, Texas, United States
Ke-Qin HU - VA Medical Center, Loma Linda, California, United States
Lennox JEFFERS - VA Medical Center, Miami, Florida, United States
Samuel B HO - VA Medical Center, Minneapolis, Minnesota, United States
David JOHNSON - VA Medical Center, Bay Pines, Florida, United States
Resource Type: Journal article
Publication Details: The American journal of gastroenterology, Vol.100(8), pp.1772-1779
Publisher: Blackwell Publishing
DOI: 10.1111/j.1572-0241.2005.41860.x
PMID: 16086714
ISSN: 0002-9270
eISSN: 1572-0241
Language: English
Date published: 2005
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094481702771

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