Rate and predictors of treatment prescription for hepatitis C

Butt, Adeel A.; Justice, Amy C.; Skanderson, Melissa; Rigsby, Michael O.; Good, Chester B.; Kent Kwoh, C.
March 2007
Gut;Mar2007, Vol. 56 Issue 3, p385
Academic Journal
Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11 .8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non- treatment for HCV: increasing age (odds ratio (OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race (OR 0.64; 95% CI 0.6 to 0.68); Hispanic race (OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence (OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence (OR 0.78; 95% CI 0.74 to 0.82); anaemia (OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection (OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease (OR 0.9; 95% CI 0.85 to 0.97); stroke (OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder (OR 0.64; 95% CI 0.58 to 0.70); major depression (OR 0.72; 95% CI 0.67 to 0.77); mild depression (OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia (OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis (OR 1.6; 95% CI 1 .5 to 1.7); and diabetes (OR 1.07; 95% CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study.


Related Articles

  • Optimum Duration of Treatment for Hepatitis C.  // Neurology Alert;Sep2007 Supplement, Vol. 26, p18 

    The article discusses research on optimum duration of treatment for hepatitis C. It references a study by M. L. Shiffman et al, published in the 2007 of the "New England Journal of Medicine." The standard treatment for hepatitis C called sustained viral response (SVR) is defined as an absence of...

  • Promoting equitable access to hepatitis C treatment for Indo-Chinese injecting drug users. Coupland, Heidi; Day, Carolyn; Levy, Miriam T.; Maher, Lisa // Health Promotion Journal of Australia;Dec2009, Vol. 20 Issue 3, p234 

    Issue addressed: Increasing the uptake of hepatitis C treatment by injecting drug users (IDUs) is a key strategy in addressing the escalating disease burden of chronic hepatitis C virus (HCV) infection in Australia. Little is known about barriers to treatment uptake among culturally diverse...

  • Therapie der chronischen Hepatitis C. Schaffstein, Stella; Rampini, Silvana K.; Müllhaupt, Beat // Praxis (16618157);4/9/2014, Vol. 103 Issue 8, p423 

    No abstract available.

  • Hepatitis C Virus Infection among Injection Drug Users with and without Human Immunodeficiency Virus Co-Infection. Hsieh, Meng-Hsuan; Tsai, Jih-Jin; Hsieh, Ming-Yen; Huang, Chung-Feng; Yeh, Ming-Lun; Yang, Jeng-Fu; Chang, Ko; Lin, Wei-Ru; Lin, Chun-Yu; Chen, Tun-Chieh; Huang, Jee-Fu; Dai, Chia-Yen; Yu, Ming-Lung; Chuang, Wan-Long // PLoS ONE;Apr2014, Vol. 9 Issue 4, p1 

    The aim of this study is to explore the prevalence of hepatitis C virus (HCV) infection among injection drug users (IDUs) with and without human immunodeficiency virus (HIV) infection in southern Taiwan. For 562 IDUs (265 anti-HIV negative, 297 anti-HIV positive), we analyzed liver function,...

  • Injecting Risk Behavior among Traveling Young Injection Drug Users: Travel Partner and City Characteristics. Montgomery, Martha; Fatch, Robin; Evans, Jennifer; Yu, Michelle; Davidson, Peter; Page, Kimberly; Hahn, Judith // Journal of Urban Health;Jun2013, Vol. 90 Issue 3, p500 

    Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP),...

  • New Expensive Treatments for Hepatitis C Infection. Brennan, Troyen; Shrank, William // JAMA: Journal of the American Medical Association;8/13/2014, Vol. 312 Issue 6, p593 

    The article discusses changes in the treatment options for hepatitis C virus (HCV) infection. Topics discussed include an overview of past treatment courses involving the drugs pegylated interferon and ribavirin, the use of polymerase inhibitors as the standard course of treatment in 2014, and...

  • Once-daily simeprevir with peginterferon and ribavirin for treatment-experienced HCV genotype 1-infected patients in Japan: the CONCERTO-2 and CONCERTO-3 studies. Izumi, Namiki; Hayashi, Norio; Kumada, Hiromitsu; Okanoue, Takeshi; Tsubouchi, Hirohito; Yatsuhashi, Hiroshi; Kato, Mai; Ki, Rito; Komada, Yuji; Seto, Chiharu; Goto, Shoichiro // Journal of Gastroenterology;May2014, Vol. 49 Issue 5, p941 

    Background: Efficacy of available therapies for patients with HCV who have previously failed treatment is limited. Two Phase III, open-label trials in Japan investigated efficacy and safety of simeprevir and peginterferon-α-2a/ribavirin (PR) combination therapy in treatment-experienced...

  • Results of antiviral treatment of patients with chronic hepatitis C: experience of Poznan centre. Bura, Maciej; Kowala-Piaskowska, Arleta; Adamek, Agnieszka; Bura, Aleksandra; Czajka, Arkadiusz; Hryckiewicz, Katarzyna; Bereszyńska, Iwona; Mozer-Lisewska, Iwona // Advances in Hygiene & Experimental Medicine / Postepy Higieny i ;2012, Vol. 66, p339 

    Introduction: Hepatitis C virus (HCV) infection in Poland affects approximately 750 thousand persons. The prevention of cirrhosis and hepatocellular carcinoma, of which approximately 20% of patients with chronic hepatitis C virus are at risk, aims at eradication of the virus by applying...

  • Future Promise of siRNA and Other Nucleic Acid Based Therapeutics for the Treatment of Chronic HCV. Wilson, J. A.; Richardson, C. D. // Infectious Disorders - Drug Targets;Mar2006, Vol. 6 Issue 1, p43 

    RNA interference (RNAi) is gaining favor as a potential therapeutic option for the treatment of Hepatitis C virus infections. RNAi, first discovered in plants, induces sequence specific degradation of messenger RNA following the introduction of short interference RNA (siRNA). RNAi is a natural...


Read the Article


Sign out of this library

Other Topics