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Patterns and predictors of treatment initiation and completion in patients with chronic hepatitis C virus infection

Brian T Clark1, Guadalupe Garcia-Tsao, Liana Fraenkel

  • 1Veterans Administration, Connecticut Healthcare System, West Haven.

Patient Preference and Adherence
|April 27, 2012
PubMed

Insights

Hepatitis C (HCV) treatment initiation is low, even for severe cases. Patient preference, not disease severity, predicts starting therapy, highlighting the need for personalized care and improved access.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection affects millions globally, with guidelines recommending antiviral therapy for severe liver disease to prevent complications.
  • Despite clear benefits, a significant majority of HCV-infected patients do not receive treatment, indicating barriers to care.
  • Understanding treatment initiation and completion patterns is crucial for improving patient outcomes.

Purpose of the Study:

  • To describe treatment initiation patterns in patients with mild and severe hepatitis C (HCV).
  • To identify factors associated with treatment initiation and completion among HCV patients.
  • To assess the role of patient choice predisposition and sociodemographic factors in treatment decisions.

Main Methods:

  • A prospective study involving 148 eligible subjects with chronic HCV.
  • Validated questionnaires assessed sociodemographic, choice predisposition, and clinical characteristics before provider consultation.
  • Subjects were followed for 12 months to track treatment initiation and completion, controlling for liver disease severity.

Main Results:

  • Only 37% of patients initiated HCV treatment within 12 months; 50% of those with severe disease initiated therapy.
  • Financial barriers and geographic access were primary reasons for deferring treatment.
  • Patient choice predisposition strongly predicted treatment initiation, independent of disease severity; sociodemographic factors did not.

Conclusions:

  • While treatment initiation aligned with recommendations for severe disease, overall rates were low.
  • Patient choice predisposition emerged as the strongest predictor of initiating HCV therapy.
  • Improving HCV treatment outcomes necessitates identifying patient preferences and enhancing access to care.
Abstract

Keywords:
accessadverse eventsbarrierspreferencesutilization

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