Yngve Falck-Ytter, MD; Hemangi Kale, MD; Kevin D. Mullen, MD; Steedman A. Sarbah, MD; Lucian Sorescu, MD; Arthur J. McCullough, MD
Acknowledgment: The authors thank Diane Bringman, RN, BSN, Clinical Research Projects Coordinator, for assistance in the project.
Requests for Single Reprints: Arthur J. McCullough, MD, Division of Gastroenterology, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109-1998; e-mail, email@example.com.
Current Author Addresses: Dr. Falck-Ytter: German Cochrane Institute, Stefan-Meier-Strasse 26, 79104 Freiburg, Germany.
Drs. Kale, Mullen, Sarbah, Sorescu, and McCullough: MetroHealth Medical Center, Department of Medicine, Division of Gastroenterology, 2500 MetroHealth Drive, Cleveland, OH 44109-1998.
Author Contributions: Conception and design: Y. Falck-Ytter, K.D. Mullen, A.J. McCullough.
Analysis and interpretation of the data: Y. Falck-Ytter, H. Kale, A.J. McCullough.
Drafting of the article: Y. Falck-Ytter, K.D. Mullen, A.J. McCullough.
Critical revision of the article for important intellectual content: K.D. Mullen, A.J. McCullough.
Final approval of the article: K.D. Mullen.
Provision of study materials or patients: K.D. Mullen, A.J. McCullough.
Administrative, technical, or logistic support: Y. Falck-Ytter, H. Kale.
Collection and assembly of data: Y. Falck-Ytter, S.A. Sarbah, L. Sorescu.
Falck-Ytter Y., Kale H., Mullen K., Sarbah S., Sorescu L., McCullough A.; Surprisingly Small Effect of Antiviral Treatment in Patients with Hepatitis C. Ann Intern Med. 2002;136:288-292. doi: 10.7326/0003-4819-136-4-200202190-00008
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Published: Ann Intern Med. 2002;136(4):288-292.
The effect and applicability of interferon-based antiviral therapies in the general population of persons with hepatitis C virus (HCV) infection are unknown.
To determine the applicability and usefulness of anti-viral therapy in a metropolitan clinic population.
Retrospective case series of consecutively referred patients.
A teaching county hospital in Cleveland, Ohio.
327 patients referred to a liver clinic after a positive result for antibody against HCV on enzyme-linked immunosorbent assay (ELISA).
Treatment rates; reasons for nontreatment.
34 patients had no detectable HCV RNA. Of the remaining 293 patients, 72% were not treated for the following reasons: 37% did not adhere to evaluation procedures, 34% had medical or psychiatric contraindications, 13% had ongoing substance or alcohol abuse, 11% preferred no treatment, and 5% had normal liver enzyme levels. Only 83 patients (28%) were treated; 13% had a sustained viral response.
Most patients with HCV infection are not candidates for interferon-based therapies; alternative interventions should be sought for these patients.
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Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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