Related Experiment Video
Updated: Aug 15, 2026
Early Viral Entry Assays for the Identification and Evaluation of Antiviral Compounds
Published on: October 29, 2015
Hepatitis C infection: eligibility for antiviral therapies
Jean Delwaide1, Refaat El Saouda, Christiane Gérard
1Department of Hepato-Gastroenterology, CHU Sart Tilman, Université de Liège, Belgium. jean.delwaide@chu.ulg.ac.be
Insights
Most chronic hepatitis C virus (HCV) patients are ineligible for treatment due to medical reasons or patient choice. Fear of adverse events significantly limits treatment uptake and sustained viral response rates.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Background:
- Current hepatitis C virus (HCV) treatments are effective but costly and associated with side effects.
- High treatment costs and adverse events pose challenges in managing chronic HCV infections.
Purpose of the Study:
- To determine the proportion of chronic hepatitis C virus (HCV) patients eligible for antiviral therapy.
- To identify reasons for non-treatment and therapy discontinuation in HCV patients.
Main Methods:
- Retrospective review of 299 viraemic HCV patients' medical records from 1996-2003.
- Analysis of patient demographics, risk factors, HCV genotypes, treatment eligibility, and outcomes.
Main Results:
- Only 41% of reviewed HCV patients received treatment; 59% were not treated due to medical contraindications (34%), non-compliance (25%), or normal transaminases (24%).
- A significant proportion (17%) declined treatment despite eligibility, primarily due to fear of adverse events.
- Sustained viral response was achieved in 41% of treated patients, with 16% discontinuing therapy due to adverse events.
Conclusions:
- The majority of chronic HCV patients are not candidates for current treatments, limiting sustained response rates to approximately 17%.
- Modifying treatment guidelines to include patients with normal transaminases could increase treatment rates.
- Patient and physician apprehension regarding adverse events remains a substantial barrier to effective HCV treatment.
Background:
Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects.
Objectives:
To evaluate the proportion of HCV patients who are eligible for a treatment.
Methods:
In a database comprising 1726 viraemic HCV patients, the files of 299 patients who presented to the same hepatologist for an initial appointment between 1996 and 2003 were reviewed.
Results:
Patients' characteristics were age 43.1 +/- 15.6 years, 53% male and 92% Caucasian. The main risk factors were transfusion (43%) and drug use (22%). Genotypes were mostly genotype 1 (66%), genotype 3 (12%) and genotype 2 (10%). These characteristics were not different from those of the whole series of 1726 patients. A total of 176 patients (59%) were not treated, the reasons for non-treatment being medical contraindications (34%), non-compliance (25%) and normal transaminases (24%). In addition, 17% of patients declined therapy despite being considered as eligible, mainly due to fear of adverse events. Medical contraindications were psychiatric (27%), age (22%), end-stage liver disease (15%), willingness for pregnancy (13%), cardiac contraindication (7%) and others (16%). Only 123 patients (41%) were treated. A sustained viral response was observed in 41%. The treatment was interrupted in 16% for adverse events.
Conclusions:
The majority of HCV patients are not eligible for treatment. This implies that, with current therapies, only 17% of patients referred for chronic HCV become sustained responders. Some modifications of guidelines could extend the rate of treatment (patients with normal transaminases), but an important barrier remains the patients' and the doctors' fear of adverse events.
Related Concept Videos
01:25Hepatitis
01:10Retrovirus Life Cycles
01:28Viral Hepatitis I: Introduction
01:22Antiviral Nucleoside Inhibitors
01:30Inhibitors of Viral Protein Synthesis
01:27Cytomegalovirus Disease