Adherence to Chronic Hepatitis C Treatment Regimen: First Report From a Referral Center in Iran

Abstract

BackgroundVarious aspects of adherence to HCV treatment such as frequency, risk factors as well as causes of non-adherence, and its real role in clinical and virological outcome of the infected patients have remained largely unknown.ObjectivesThe current study aimed to evaluate patients’ adherence to anti-HCV medications in Iran.Materials and MethodsFrom October 2010 to March 2011, socio-demographic characteristics, features of HCV infection, clinical properties, and habitual history of 190 patients were collected. Adherence of each patient to anti-HCV medications was determined at months 1, 3, and 6 of treatment by self-reporting and pill or empty ampoule counting. Adherence to anti-HCV treatment regimen was determined based on the 80/80/80 rule.ResultsAdherence rate to interferon, ribavirin, or a combination of them over the first 6 months of therapy in Iranian HCV patients measured by both methods of self-reporting and pill counting were 35.4-65.8%, 46.3-56.8%, and 28.4-51.1%, respectively. Delay in receiving new prescription, financial issues, and adverse drug reactions were the most common causes of non-adherence in the patients. Adherence to ribavirin was identified as an independent predictor of achieving the end of treatment response, or sustained virological response.ConclusionsThe rate of adherence to interferon and ribavirin varied significantly according to the method of calculation. Over the treatment course, adherence to interferon alpha and ribavirin, each or their combination, diminished significantly.

Adherence to prescribed medications of Iranian traditional medicine in a group of patients with chronic disease

“…[ 22 24 30 31 32 33 ] Overestimation is a limitation of this method and reliability of the self-reporting questionnaire closely depends on the level of literacy and the cognitive ability of individuals. [ 34 ] Despite these issues, a meta-analysis of 65 studies has demonstrated that self-reporting is a valid method for assessing the adherence to antiretroviral medications. [ 35 ]…”

Hepatitis C asociada al abuso de sustancias: nunca tan cerca de un tratamiento sin Interferón

“…Una revisión sistemática reciente sobre usuarios de drogas elegibles para el tratamiento del VHC con PEG-IFN y RBV mostró una RVS global del 56% (37% para genotipos 1/4 y 67% para 2/3) (Aspinall et al, 2013); estas cifras son algo inferiores a las de la mayoría de ensayos clínicos para estos fármacos, si bien son similares a las descritas en dos estudios de efectividad del tratamiento (39%-46% para genotipo 1 y 70%-84% para genotipo 2/3) (Borroni et al, 2008;Innes et al, 2012). En esta misma revisión sistemática (Aspinall et al, 2013) se observó una elevada adherencia al tratamiento, del 83%, algo superior a la mostrada en pacientes no usuarios de drogas (McHutchison et al, 2002;Ravi, Nasiri Toosi, Karimzadeh, Ahadi-Barzoki, y Khalili, 2013), si bien las diferencias observadas se explicarían por la propia definición de adherencia; además, la tasa de reinfección por VHC fue moderada (2.4 por 100p-a) sugiriendo que ésta tiene poco impacto en la efectividad del tratamiento a largo plazo (Aspinall et al, 2013).…”

The efficacy of adding vitamin B12 to pegylated interferon and ribavirin treatment in Hepatitis C virus patients regarding the host and viral prognostic factors

“…These new treatments improve SVR rates significantly in difficult cases such as genotype 1 HCV infection 13 . Despite these advantages, in most of low-and middle income countries including Iran, access to these drugs is limited, mostly due to their high cost and unavailability 14 . Population based epidemiological studies have estimated that the prevalence of HCV in the Iranian general population is less than 0.5%, which is relatively low 15 .…”