Most people with hepatitis C go untreated, despite effective drugs

December 10, 2012 by Laura Kennedy

Just 20 percent of people infected with the hepatitis C virus (HCV) begin the recommended treatment regimen and less than 5 percent go on to successfully overcome the virus, according to a new review in General Hospital Psychiatry. This is despite the availability of highly effective anti-viral drugs that clear hepatitis C virus in about 80 percent of patients participating in clinical trials. Major barriers to recommended care are substance abuse and depression in HCV patients.

Other barriers to treatment include patients' attitudes toward treatment, including a fear of the side effects associated with some of the anti-viral drugs and an inability or unwillingness to abstain from drugs or alcohol, which is required for successful treatment.

As many as 4 million Americans have , which is a blood-borne viral infection that is the most common cause of severe liver disease and in the United States. In the past, hepatitis C was sometimes transmitted during medical procedures such as blood transfusions but this risk has been significantly reduced. The illicit use of injection drugs is the primary source of new infections.

People who engage in high-risk behavior in their youth often don't realize they have HCV until they reach middle age and are diagnosed with end-stage liver disease, said Barry Hong, Ph.D., of Washington University School of Medicine in St. Louis, a coauthor of the review. Recently, the Centers for Disease Control and Prevention recommended that all be screened for HCV.

"Screening patients with psychiatric and substance use disorders is also a must," notes Muhamad Aly Rifai, M.D., a psychiatrist specializing in mental illness and at the Commonwealth Medical College in Pennsylvania.

The findings suggest that many of these barriers to care can be readily addressed through education or by treating patients' mental conditions before or during treatment for HCV, including the use of anti-depressants, the authors suggest.

In addition to their high risk health behaviors, many also face practical barriers to accessing treatment such as lack of transportation, good social supports, or adequate housing. The authors recommend providing a multidisciplinary treatment approach that involves social workers, physician assistants and others to provide assistance.

The review also "underscores the need for better anti-HCV regimens with fewer side effects," notes Frederick Askari, M.D., Ph.D., a hepatologist at the University of Michigan Medical Center. "Fortunately better treatments are on the horizon, with over 20 promising compounds in various stages of clinical development."

More information: North C., et al. Hepatitis c treatment and SVR: the gap between clinical trials and real-world treatment aspirations. General Hospital Psychiatry, 2012.

Related Stories

New vaccine for hepatitis C virus

July 28, 2011

Murdoch University researchers have begun a study to develop a new and innovative vaccine for the hepatitis C virus (HCV).

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.