Treatment Practices Regarding Management of Patients with Hepatitis
C Infection Non-Responders to Antiviral Therapy
Hotel-Dieu, Lyon, France; Multicenter - NOREVIC Group, France
To explore through a National French prospective survey, treatment practices regarding HCV patients non-responders (NR) to antiviral therapy.
Patients and Methods
HCV patients NR to at least one antiviral treatment and consecutively observed in 27 French Hepatology Centres were recruited. A standardised questionnaire regarding clinical history and treatment was used for each patient.
Three hundred eighty nine NR patients were included from May 2002 to October 2003. Sixty percent of them were males and the mean age was 52 years. Eighty percent had a genotype 1 and the median duration of infection was 23 years. At inclusion, 52% of the patients were under treatment. The main reason for not being treated was medical decision in 67% of cases, patient refusal in 14%, and another reason in 19% (the majority were waiting for inclusion in a clinical trial). Cessation of treatment was mostly due to lack of response (38%), therapeutic window (28%) and intolerance (26%).
Among patients starting a new therapy at inclusion, 54% were enrolled into a clinical trial. Among patients under treatment, 30% were treated by bitherapy (83% by PEG-IFN/ribavirin), 28% by tritherapy (77% by PEG-IFN/ribavirin/amantadine), 28% by monotherapy (mostly by PEG IFN(61%), while 15% had another therapy.
Fifty-one percent of patients with cirrhosis had no treatment. Among treated cirrhotic patients 47% were treated by monotherapy (71% by IFN, 29% by ribavirin), 28% had a PEG IFN/ribavirin bitherapy.
Maintenance therapy is widely used in France although 50% of cirrhotic patients remain untreated.
Thank you, Hep C Advocate
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