Waiting for Interferon-free Regimens for Chronic Hepatitis C Patients: A Multicenter Observational Study

Abstract

Objectives: This study aims to determine the reasons for not being able to access treatment of chronic hepatitis C (CHC) for patients who are followed up without treatment and to serve as a resource for future studies to be conducted to find solutions. Materials and Methods: The study was planned as a multi-center observational study. Universities, training and research hospitals, and public hospitals from different regions, most of which are members of the Association to Combat Viral Hepatitis-Academic Camp, participated in the study. The reasons for untreated follow-up of CHC patients followed up without treatment were investigated. Patients who were hepatitis C virus (HCV) RNA negative, who had sustained viral response, and who had been receiving treatment were excluded from the study. Results: Two hundred and ninety patients diagnosed with CHC and followed up without treatment were reviewed in detail. The median age was 58 (23-87) years, the number of female patients was 157 (54%); 241 patients were genotype 1 (83%), 12 patients were genotype 2, 3 and 4 (4%), 37 patients were of unidentified genotypes (13%); 174 patients (60%) were treatment-naïve; and 14 patients (12%) out of the Amaç: Bu çalışmada, tedavisiz izlenen kronik hepatit C (KHC) hastalarının, tedavisiz kalma nedenlerinin ortaya konması ve ileriye dönük çözüm önerilerinin oluşturulması amaçlanmıştır. Gereç ve Yöntemler: Çalışma çok merkezli, gözlemsel çalışma olarak planlandı. Viral Hepatitle Savaşım Derneği-Akademik Kamp üyesi olan merkezlerin çoğunluğunu oluşturduğu farklı bölgelerden üniversite, eğitim araştırma ve devlet hastaneleri çalışmaya katıldı. Tedavisiz izlenen KHC hastalarının tedavisiz izlem nedenleri irdelendi. Hepatit C virüsü (HCV) RNA negatif olan, kalıcı viral yanıtı bulunan ve tedavi almakta olan hastalar çalışma dışı bırakıldı. Bulgular: KHC tanısı olup tedavisiz izlenen 290 hasta ayrıntılı olarak incelendi. Ortanca yaş 58 (23-87), kadın sayısı 157 (%54); 241 hasta genotip 1 (%83), 12 hasta genotip 2, 3 ve 4 (%4), genotipi belirtilmeyen 37 (%13); 174 hasta (%60) naiv; tedavi deneyimlilerden 14'ü (%12) kısmi yanıtlı, 41'i (%36) yanıtsız, 58'i (%51) relapser idi.

Sixteen-year Prognosis of Treatment-naive Patients with Hepatitis C Infection

“…In the present study, about half of the patients remained untreated because they could not use IFN-containing regimens. A similar situation was demonstrated in a study by Güner et al (14). However, our patients with observed progression were not included in this group.…”