1Department of Digestive Diseases, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
BACKGROUND AND AIMS:
1)To describe the demographic, clinical, virological and histological characteristics of the patients undergoing evaluation for indication of triple therapy against hepatitis C virus genotype 1, and to identify the reasons why candidate patients are excluded; and 2)To evaluate the characteristics of the health-care environment related to treatment.
Observational, prospective and multi-centered study involving 16 hospitals of Spain. Data were collected on 1122 patients receiving attention in the outpatient clinics between June and December 2012.
Of the 1122 patients evaluated, 769 were finally included in the study; 27% (211/769) had contraindications to the therapy. Of those without contraindications, 54%(301/558) did not receive the treatment, and so, only about a third of the patients (33%-257/769) underwent therapy. The reasons for not initiating therapy were: patient refusal (30%), mild disease/awaiting new treatments (34%), restrictions by the health service (30%), other reasons (6%). In univariate analyses the probability of receiving treatment was related to: age <60 years, male gender, high education level, advanced fibrosis, having had previous treatment, being assessed in a center of excellence. In multivariate analyses the factors independently related to the probability of receiving treatment were: high education level of the patients (p 0.004), advanced fibrosis (p< 0.001), and centers of excellence (p 0.009).
Despite the high efficacy of triple therapy, only a small proportion of patients receive the treatment. The causes related to non-treatment depend on patient factors, disease stage and characteristics of the health-service provision.