Clinical outcomes in a cohort of anti-hepatitis C virus-positive patients with significant barriers to treatment referred to a Norwegian outpatient clinic

Abstract

Objective. Patient selection and management of chronic hepatitis C (CHC) in Norwegian outpatient clinics is not well studied. The aim of the study was to characterize CHC patients referred to a large university hospital in Norway, identify treatment barriers, and investigate the course and outcomes of treatment. Material and methods. In this retrospective observational cohort study, all anti-HCV-positive patients referred to Haukeland University Hospital, Bergen, for treatment evaluation during the period 2007–2010 were included. Demographics, clinical, laboratory, and treatment results were obtained from electronic medical records. Results. A total of 256 patients were included. The patients were young (mean age 36 ± 10.3), with a high prevalence of genotypes 3 (55%) and 1 (43%) and low levels of fibrosis (77% <F2). The majority of patients were former or current injection drug users (85%). Treatment uptake among patients attending the clinic was 47% (n = 91). Treatment was significantly less common in patients who were unemployed, those who had nonattendances during clinical evaluation, those with genotypes 1 or 4, those ≥50 years of age, and patients with no biopsy. For patients initiating treatment, the total sustained virologic response (SVR) rate was 63% (by complete case analysis 73%). For genotypes 1 and 3, SVR was achieved in 44% and 75%, respectively, by intention to treat. Conclusions. A high treatment uptake of CHC patients in a cohort with high prevalence of injection drug use was found. Young age, low degrees of fibrosis, and good patient attendance ensured a high rate of SVR.

Key Words::

• chronic
• drug users
• hepatitis C
• Norway
• outpatients

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.