HCV Treatment Initiation Rates Increase With Education, Awareness

Increased knowledge of hepatitis C virus (HCV) in patients with HCV who are receiving methadone maintenance treatment (MMT) improves rates of treatment initiation among these patients, according to a recent study. Findings from the study were presented by Rafael Bruck at the 5th World Congress on Hepatitis & Liver Diseases on August 11, 2017, in London.

Major obstacles to HCV treatment among patients receiving MMT include a lack of information about the disease, as well as administrative difficulties.
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In their study, Bruck and colleagues identified 80 eligible HCV seropositive patients without psychiatric disorders at the Adelson Clinic, Israel, rehabilitation center who had been abstinent for at least 3 months. Patients were invited to attend a lecture about HCV led by a hepatologist. Standard HCV treatment throughout the study was PEG-RIBA+PI (telaprevir).

HCV knowledge and depression questionnaires were administered to patients before and after the lecture, and were subsequently referred to the Tel Aviv Medical Center Liver Unit for evaluation and treatment.

A total of 48 eligible patients attended the lecture. Patients who had attended scored significantly better on the HCV knowledge questionnaire following the lecture, compared with those who did not attend. According to Bruck, lecture attendance predicted referral to treatment, and 41 attendees were referred to treatment.

Of the 41 attendees who were referred, 21 had presented to the treatment center and had had lower depression scores. Despite administrative difficulties, 15 patients started evaluation, 12 initiated interferon-based antiviral treatment, and 9 subjects achieved sustained viral response. However, 1 patient did not respond to treatment, and 2 had discontinued treatment due to adverse events.

Of the 59 patients who did not present to the treatment center, 14 were followed elsewhere. However, only 1 of 14 patients had started treatment.

“Attendance in a single lecture about HCV improved knowledge and enhanced HCV treatment initiation among MMT patients, but was adversely affected by depression,” Bruck concluded. “In MMT patients, interventions aimed to minimize administrative difficulties and to increase knowledge and awareness to the disease, as well as treatment of depression are necessary. These measures might be even more effective at present, when safe and effective IFN-free therapies to eradicate HCV are widely available.”

—Christina Vogt

Reference:

Bruck R. Improvement of patients' understanding and accessibility to healthcare services increase implementation of hepatitis C virus therapy in methadone maintenance treatment patients. Paper presented at: 5th World Congress on Hepatitis & Liver Diseases; August 10-12, 2017. London, UK. http://hepatitis.conferenceseries.com/abstract/2017/improvement-of-patients-understanding-and-accessibility-to-healthcare-services-increase-implementation-of-hepatitis-c-virus-therapy-in-methadone-maintenance-treatment-patients.