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Surprisingly Small Effect of Antiviral Treatment in Patients with Hepatitis C

Yngve Falck-Ytter, MD; Hemangi Kale, MD; Kevin D. Mullen, MD; Steedman A. Sarbah, MD; Lucian Sorescu, MD; and Arthur J. McCullough, MD
[+] Article, Author, and Disclosure Information

From MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio.

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, ajm3@po.cwru.edu.

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.

Ann Intern Med. 2002;136(4):288-292. doi:10.7326/0003-4819-136-4-200202190-00008
Text Size: A A A

Background: The effect and applicability of interferon-based antiviral therapies in the general population of persons with hepatitis C virus (HCV) infection are unknown.

Objective: To determine the applicability and usefulness of anti-viral therapy in a metropolitan clinic population.

Design: Retrospective case series of consecutively referred patients.

Setting: A teaching county hospital in Cleveland, Ohio.

Patients: 327 patients referred to a liver clinic after a positive result for antibody against HCV on enzyme-linked immunosorbent assay (ELISA).

Measurements: Treatment rates; reasons for nontreatment.

Results: 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.

Conclusion: Most patients with HCV infection are not candidates for interferon-based therapies; alternative interventions should be sought for these patients.


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Reasons for nontreatment with interferon in patients with hepatitis C virus infection.

ALT = alanine aminotransferase.

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Summary for Patients

Who Gets Antiviral Treatment for Hepatitis C?

The summary below is from the full report titled “Surprisingly Small Effect of Antiviral Treatment in Patients with Hepatitis C.” It is in the 19 February 2002 issue of Annals of Internal Medicine (volume 136, pages 288-292). The authors are Y Falck-Ytter, H Kale, KD Mullen, SA Sarbah, L Sorescu, and AJ McCullough.


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