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1Department of Digestive Diseases, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Abstract
BACKGROUND AND AIMS:
1)To describe the demographic, clinical, virological and histological characteristics of the patients undergoing evaluation for indication of triple therapy against hepatitis C virus genotype 1, and to identify the reasons why candidate patients are excluded; and 2)To evaluate the characteristics of the health-care environment related to treatment.
METHODS:
Observational, prospective and multi-centered study involving 16 hospitals of Spain. Data were collected on 1122 patients receiving attention in the outpatient clinics between June and December 2012.
RESULTS:
Of the 1122 patients evaluated, 769 were finally included in the study; 27% (211/769) had contraindications to the therapy. Of those without contraindications, 54%(301/558) did not receive the treatment, and so, only about a third of the patients (33%-257/769) underwent therapy. The reasons for not initiating therapy were: patient refusal (30%), mild disease/awaiting new treatments (34%), restrictions by the health service (30%), other reasons (6%). In univariate analyses the probability of receiving treatment was related to: age <60 years, male gender, high education level, advanced fibrosis, having had previous treatment, being assessed in a center of excellence. In multivariate analyses the factors independently related to the probability of receiving treatment were: high education level of the patients (p 0.004), advanced fibrosis (p< 0.001), and centers of excellence (p 0.009).
CONCLUSION:
Despite the high efficacy of triple therapy, only a small proportion of patients receive the treatment. The causes related to non-treatment depend on patient factors, disease stage and characteristics of the health-service provision.