Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection
Objectives. Treatment with pegylated interferon and ribavirin may prevent progression of liver disease among patients with chronic hepatitis C virus infection (HCV). Treatment initiation is based on published clinical eligibility criteria, patients’ willingness to undergo treatment and li...
Published in: | International Journal of Circumpolar Health |
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2012
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Online Access: | https://doi.org/10.3402/ijch.v71i0.18445 https://doaj.org/article/ef0d9862c24241b1b17d87c721f8f10f |
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ftdoajarticles:oai:doaj.org/article:ef0d9862c24241b1b17d87c721f8f10f 2023-05-15T15:10:39+02:00 Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection Stephen E. Livingston Lisa J. Townshend-Bulson Dana L. Bruden Brian J. McMahon Chriss E. Homan James E. Gove Heike Deubner Michael G. Bruce Renee F. Robinson David R. Gretch 2012-04-01T00:00:00Z https://doi.org/10.3402/ijch.v71i0.18445 https://doaj.org/article/ef0d9862c24241b1b17d87c721f8f10f EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/18445/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v71i0.18445 2242-3982 https://doaj.org/article/ef0d9862c24241b1b17d87c721f8f10f International Journal of Circumpolar Health, Vol 71, Iss 0, Pp 1-7 (2012) hepatitis C treatment hepatology clinics treatment eligibility Arctic medicine. Tropical medicine RC955-962 article 2012 ftdoajarticles https://doi.org/10.3402/ijch.v71i0.18445 2022-12-31T03:46:49Z Objectives. Treatment with pegylated interferon and ribavirin may prevent progression of liver disease among patients with chronic hepatitis C virus infection (HCV). Treatment initiation is based on published clinical eligibility criteria, patients’ willingness to undergo treatment and likelihood of success. We examined treatment eligibility in a cohort of Alaska Native and American Indian persons with chronic HCV infection. Study design. Retrospective cohort study. Methods. Medical records of all treatment naïve HCV RNA positive patients given an appointment by hepatology specialty clinic staff in 2003 and 2007 were evaluated by a hepatology provider to investigate documented reasons for treatment deferral. Results. Treatment was initiated in 4 of 94 patients (4%) in 2003 and 14 of 146 patients (10%) in 2007. Major reasons for treatment deferral in 2003 versus 2007 included inconsistent appointment attendance (36% of deferrals vs. 18%), active substance abuse (17% vs. 22%), patient decision (17% vs. 27%), liver biopsy without fibrosis or normal ALT (8% vs. 3%), uncontrolled psychiatric condition (7% vs. 7%) and concurrent medical condition (6% vs. 9%). There was significant improvement in proportion of appointments attended in 2007 versus 2003 (76% vs. 67%, p = 0.04) and the percentage of patients attending at least 1 appointment (84% vs. 66%, p = 0.002). Conclusions. Multiple reasons for treatment deferral were documented. Despite a significant improvement in hepatology clinic attendance and an increase in the number of patients started on treatment in 2007 compared to 2003, the overall percentage of those treated remained low. Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health Alaska Directory of Open Access Journals: DOAJ Articles Arctic Indian International Journal of Circumpolar Health 71 1 18445 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
hepatitis C treatment hepatology clinics treatment eligibility Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
hepatitis C treatment hepatology clinics treatment eligibility Arctic medicine. Tropical medicine RC955-962 Stephen E. Livingston Lisa J. Townshend-Bulson Dana L. Bruden Brian J. McMahon Chriss E. Homan James E. Gove Heike Deubner Michael G. Bruce Renee F. Robinson David R. Gretch Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
topic_facet |
hepatitis C treatment hepatology clinics treatment eligibility Arctic medicine. Tropical medicine RC955-962 |
description |
Objectives. Treatment with pegylated interferon and ribavirin may prevent progression of liver disease among patients with chronic hepatitis C virus infection (HCV). Treatment initiation is based on published clinical eligibility criteria, patients’ willingness to undergo treatment and likelihood of success. We examined treatment eligibility in a cohort of Alaska Native and American Indian persons with chronic HCV infection. Study design. Retrospective cohort study. Methods. Medical records of all treatment naïve HCV RNA positive patients given an appointment by hepatology specialty clinic staff in 2003 and 2007 were evaluated by a hepatology provider to investigate documented reasons for treatment deferral. Results. Treatment was initiated in 4 of 94 patients (4%) in 2003 and 14 of 146 patients (10%) in 2007. Major reasons for treatment deferral in 2003 versus 2007 included inconsistent appointment attendance (36% of deferrals vs. 18%), active substance abuse (17% vs. 22%), patient decision (17% vs. 27%), liver biopsy without fibrosis or normal ALT (8% vs. 3%), uncontrolled psychiatric condition (7% vs. 7%) and concurrent medical condition (6% vs. 9%). There was significant improvement in proportion of appointments attended in 2007 versus 2003 (76% vs. 67%, p = 0.04) and the percentage of patients attending at least 1 appointment (84% vs. 66%, p = 0.002). Conclusions. Multiple reasons for treatment deferral were documented. Despite a significant improvement in hepatology clinic attendance and an increase in the number of patients started on treatment in 2007 compared to 2003, the overall percentage of those treated remained low. |
format |
Article in Journal/Newspaper |
author |
Stephen E. Livingston Lisa J. Townshend-Bulson Dana L. Bruden Brian J. McMahon Chriss E. Homan James E. Gove Heike Deubner Michael G. Bruce Renee F. Robinson David R. Gretch |
author_facet |
Stephen E. Livingston Lisa J. Townshend-Bulson Dana L. Bruden Brian J. McMahon Chriss E. Homan James E. Gove Heike Deubner Michael G. Bruce Renee F. Robinson David R. Gretch |
author_sort |
Stephen E. Livingston |
title |
Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
title_short |
Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
title_full |
Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
title_fullStr |
Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
title_full_unstemmed |
Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection |
title_sort |
treatment eligibility in alaska native and american indian persons with hepatitis c virus infection |
publisher |
Taylor & Francis Group |
publishDate |
2012 |
url |
https://doi.org/10.3402/ijch.v71i0.18445 https://doaj.org/article/ef0d9862c24241b1b17d87c721f8f10f |
geographic |
Arctic Indian |
geographic_facet |
Arctic Indian |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
op_source |
International Journal of Circumpolar Health, Vol 71, Iss 0, Pp 1-7 (2012) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/18445/pdf_1 https://doaj.org/toc/2242-3982 doi:10.3402/ijch.v71i0.18445 2242-3982 https://doaj.org/article/ef0d9862c24241b1b17d87c721f8f10f |
op_doi |
https://doi.org/10.3402/ijch.v71i0.18445 |
container_title |
International Journal of Circumpolar Health |
container_volume |
71 |
container_issue |
1 |
container_start_page |
18445 |
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1766341640018984960 |