Who Gets Treated for Hepatitis C?

[Guest guest]

Who Gets Treated for Hepatitis C?

By Liz Highleyman

Many people with chronic hepatitis C virus (HCV) infection never receive treatment, for reasons ranging from minimal liver damage, to active substance use, to doctors fears about poor adherence.As reported in the September 26, 2006 electronic edition of Gut, researchers conducted a study to determine the rate of hepatitis C treatment prescription and predictors of treatment in a large cohort of U.S. veterans. They used the Department of Veterans Affairs (VA) National Patient Care Database to identify all HCV-infected persons receiving care between 1999 and 2003. Demographic information, medical and psychiatric co-morbidities, and drug and alcohol use diagnoses were retrieved from patient records. Pharmacy data was retrieved from the VA Pharmacy Benefits Management database. Results

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113,927 veterans under VA care with a diagnosis of HCV were identified.

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The treatment prescription rate for hepatitis C was 11.8%.

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Patients not prescribed treatment were:

- Older;- More likely to be of a minority race;- More likely to use alcohol and/or illegal drugs;- More likely to have medical and psychiatric co-morbid conditions.

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In a multivariate logistic regression model, the following factors predicted non-treatment of HCV:

- Increasing age (OR 0.77 for each 5 year increment);- Black (OR 0.64) or Hispanic (OR 0.88) race;- Alcohol (OR 0.62) or drug (OR 0.78) "abuse and dependence"; - Presence of anemia (OR 0.18); - Hepatitis B co-infection (OR 0.72); - History of stroke (OR 0.75); - Coronary artery disease (OR 0.90); - Mild depression (OR 0.56); - Major depression (OR 0.72); - Bipolar disorder (OR 0.64); - Schizophrenia (OR 0.71).

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Factors associated with a higher likelihood of treatment for HCV were:

- Liver cirrhosis (OR 1.60); - Diabetes (OR 1.07).

ConclusionIn conclusion, the authors wrote, "A small number of HCV infected veterans are prescribed treatment for HCV. Non-treatment is associated with increasing age, black race, drug and alcohol abuse and dependence and co-morbid illnesses."These results suggest that many patients with hepatitis C are needlessly missing out on the benefits of treatment. The most recent National Institutes of Health consensus statement on hepatitis C treatment no longer recommends that active substance users be categorically excluded from anti-HCV therapy.

Medical conditions like anemia and psychiatric conditions like depression do present additional challenges during treatment, but in many cases these can be managed with adjunct medications such as antidepressants.

10/20/06

ReferenceA A Butt, A C Justice, M Skanderson, and others. Rate and predictors of treatment prescription for hepatitis C. Gut. September 27, 2006 [Epub ahead of print].

http://www.hivandhepatitis.com/hep_c/news/2006/102006_a.html

[Guest guest]

That's interesting because I have a pre-existing condition of depression and bipolar disorder and neither kept me from treatment. I guess it is the doctor's discretion on that. And, I'm being treated by the VA.

Ally

On 10/20/06, elizabethnv1 <elizabethnv1@...> wrote:

Who Gets Treated for Hepatitis C?By Liz HighleymanMany people with chronic hepatitis C virus (HCV) infection never receive treatment, for reasons ranging from minimal liver damage, to active substance use, to doctors fears about poor adherence.

As reported in the September 26, 2006 electronic edition of Gut, researchers conducted a study to determine the rate of hepatitis C treatment prescription and predictors of treatment in a large cohort

of U.S. veterans. They used the Department of Veterans Affairs (VA) National Patient Care Database to identify all HCV-infected persons receiving care between 1999 and 2003. Demographic information, medical and psychiatric co-morbidities, and drug and alcohol use diagnoses were retrieved from patient records. Pharmacy data was retrieved from the VA Pharmacy Benefits Management database. Results• 113,927 veterans under VA care with a diagnosis of HCV were

identified. • The treatment prescription rate for hepatitis C was 11.8%. • Patients not prescribed treatment were: - Older;- More likely to be of a minority race;- More likely to use alcohol and/or illegal drugs;

- More likely to have medical and psychiatric co-morbid conditions. • In a multivariate logistic regression model, the following factors predicted non-treatment of HCV: - Increasing age (OR 0.77 for each 5 year increment);

- Black (OR 0.64) or Hispanic (OR 0.88) race;- Alcohol (OR 0.62) or drug (OR 0.78) " abuse and dependence " ; - Presence of anemia (OR 0.18); - Hepatitis B co-infection (OR 0.72); - History of stroke (OR 0.75); - Coronary artery disease (OR 0.90); - Mild depression (OR 0.56); - Major depression (OR 0.72); - Bipolar disorder (OR 0.64); - Schizophrenia (OR 0.71). • Factors associated with a higher likelihood of treatment for HCV were: - Liver cirrhosis (OR 1.60); - Diabetes (OR 1.07). ConclusionIn conclusion, the authors wrote, " A small number of HCV infected veterans are prescribed treatment for HCV. Non-treatment is associated with increasing age, black race, drug and alcohol abuse and dependence and co-morbid illnesses. " These results suggest that many patients with hepatitis C are needlessly missing out on the benefits of treatment. The most recent National Institutes of Health consensus statement on hepatitis C treatment no longer recommends that active substance users be categorically excluded from anti-HCV therapy. Medical conditions like anemia and psychiatric conditions like depression do present additional challenges during treatment, but in many cases these can be managed with adjunct medications such as antidepressants.10/20/06

[Guest guest]

I think each treating doctor makes the decision to treat or not treat based on their own opinions ,lol

Re: Who Gets Treated for Hepatitis C?

That's interesting because I have a pre-existing condition of depression and bipolar disorder and neither kept me from treatment. I guess it is the doctor's discretion on that. And, I'm being treated by the VA.

Ally

On 10/20/06, elizabethnv1 <elizabethnv1earthlink (DOT) net> wrote:

Who Gets Treated for Hepatitis C?By Liz HighleymanMany people with chronic hepatitis C virus (HCV) infection never receive treatment, for reasons ranging from minimal liver damage, to active substance use, to doctors fears about poor adherence. As reported in the September 26, 2006 electronic edition of Gut, researchers conducted a study to determine the rate of hepatitis C treatment prescription and predictors of treatment in a large cohort of U.S. veterans. They used the Department of Veterans Affairs (VA) National Patient Care Database to identify all HCV-infected persons receiving care between 1999 and 2003. Demographic information, medical and psychiatric co-morbidities, and drug and alcohol use diagnoses were retrieved from patient records. Pharmacy data was retrieved from the VA Pharmacy Benefits Management database. Results• 113,927 veterans under VA care with a diagnosis of HCV were identified. • The treatment prescription rate for hepatitis C was 11.8%. • Patients not prescribed treatment were: - Older;- More likely to be of a minority race;- More likely to use alcohol and/or illegal drugs; - More likely to have medical and psychiatric co-morbid conditions. • In a multivariate logistic regression model, the following factors predicted non-treatment of HCV: - Increasing age (OR 0.77 for each 5 year increment); - Black (OR 0.64) or Hispanic (OR 0.88) race;- Alcohol (OR 0.62) or drug (OR 0.78) "abuse and dependence"; - Presence of anemia (OR 0.18); - Hepatitis B co-infection (OR 0.72); - History of stroke (OR 0.75); - Coronary artery disease (OR 0.90); - Mild depression (OR 0.56); - Major depression (OR 0.72); - Bipolar disorder (OR 0.64); - Schizophrenia (OR 0.71). • Factors associated with a higher likelihood of treatment for HCV were: - Liver cirrhosis (OR 1.60); - Diabetes (OR 1.07). ConclusionIn conclusion, the authors wrote, "A small number of HCV infected veterans are prescribed treatment for HCV. Non-treatment is associated with increasing age, black race, drug and alcohol abuse and dependence and co-morbid illnesses."These results suggest that many patients with hepatitis C are needlessly missing out on the benefits of treatment. The most recent National Institutes of Health consensus statement on hepatitis C treatment no longer recommends that active substance users be categorically excluded from anti-HCV therapy. Medical conditions like anemia and psychiatric conditions like depression do present additional challenges during treatment, but in many cases these can be managed with adjunct medications such as antidepressants.10/20/06

[Guest guest]

In a message dated 10/20/2006 10:18:44 AM Central Daylight Time, 4thMoon@... writes:

That's interesting because I have a pre-existing condition of depression and bipolar disorder and neither kept me from treatment. I guess it is the doctor's discretion on that. And, I'm being treated by the VA.

Ally

ahh me too....one doctor didnt want to treat me since he was afraid of my depression and thought I would sue him if i killed myself..lol geri

[Guest guest]

>

>

>

> In a message dated 10/20/2006 10:18:44 AM Central Daylight Time,

> 4thMoon@... writes:

>

> That's interesting because I have a pre-existing condition of

depression and

> bipolar disorder and neither kept me from treatment. I guess it is

the

> doctor's discretion on that. And, I'm being treated by the VA.

>

> Ally

>

>

>

>

> ahh me too....one doctor didnt want to treat me since he was

afraid of my

> depression and thought I would sue him if i killed myself..lol geri

>

I was put on 50mg of Paxil about 6 weeks before treatment.I believe

the meds deplete the Serotonin in your brain.I had the ultra

sound,then the biopsy[totally painless] and then started the meds.I

cleared in 4 weeks[undetectable],am now in week 11 and the side

effect issue for me is only a dry mouth.I do take Ambien for sleep

and they have cut my interferon in half because of low platelettes.A

lot of the horror stories I read before treatment were just

overblown.For me it's been no big deal,coming off heroin cold turkey

was a big deal,this is a cakewalk compared to that.

Steve