Direct-Acting Antiviral Therapy for Hepatitis C: Attitudes Regarding Future Use
Response to current therapy of hepatitis C virus (HCV) is suboptimal. Direct-acting antiviral therapies (DAA) are expected to improve treatment outcomes. Additional treatments for HCV will invariably make therapeutic choices and patient management more complex. We hypothesize that current perceptions regarding the complexity of DAA therapy will influence attitudes towards future use by practitioners who are currently treating HCV.
An Internet-based survey was sent to 10,082 AASLD and AGA members to determine if they treat HCV infection, their knowledge of DAA therapies, attitudes towards current and future HCV treatments, and if they participated in clinical trials using DAA agents.
Out of a total of 1,757 individuals responding to the survey, 75% treat HCV; 79% were MDs, 67% were Gastroenterologists, and 24% were Hepatologists. Of the respondents, 77% indicated they were “very aware” or “aware” of DAA therapies, 20% participated in clinical trials, and 3% had minimal knowledge of DAA agents. Comparing treatment “today” versus in the future when DAAs were available, 85 vs. 81% would treat (p = 0.0054), 6 vs. 10% would refer to an “HCV expert” (p = 0.016), and 1% would refer to an ID specialist. Of respondents with “minimal knowledge” of DAA, 52% stated that they would use them in the future.
Although the majority of respondents appear ready to utilize DAA agents in the future, referrals to “hepatitis C experts” will increase. More than half of respondents with “minimal knowledge” of DAA therapies also appear to be willing to utilize these compounds, raising concerns regarding their inappropriate use. Broad education of healthcare providers to prevent inappropriate use of these agents will be critical.
- Williams, R (2006) Global challenges in liver disease. Hepatology 44: pp. 521-526 CrossRef
- Armstrong, GL, Wasley, A, Simard, EP (2006) The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med 144: pp. 705-714
- Ghany, MG, Strader, DB, Thomas, DL (2009) American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 49: pp. 1335-1374 CrossRef
- Manns, MP, McHutchison, JG, Gordon, SC (2001) Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 358: pp. 958-965 CrossRef
- Fried, MW, Shiffman, ML, Reddy, KR (2002) Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 347: pp. 975-982 CrossRef
- Hadziyannis, SJ, Sette, H, Morgan, TR (2004) Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 140: pp. 346-355
- Muir, AJ, Bornstein, JD, Killenberg, PG (2004) Peginterferon alfa-2b and ribavirin for the treatment of chronic hepatitis C in blacks and non-Hispanic whites. N Engl J Med 350: pp. 2265-2271 CrossRef
- Conjeevaram, HS, Fried, MW, Jeffers, LJ (2006) Peginterferon and ribavirin treatment in African American and Caucasian American patients with hepatitis C genotype 1. Gastroenterology 131: pp. 470-478 CrossRef
- Feuerstadt, P, Bunim, AL, Garcia, H (2010) Effectiveness of hepatitis C treatment with pegylated interferon and ribavirin in urban minority patients. Hepatology 51: pp. 1137-1143
- Romero-Gomez, M, Del Mar Viloria, M, Andrade, RJ (2005) Insulin resistance impairs sustained response rate to peginterferon plus ribavirin in chronic hepatitis C patients. Gastroenterology 128: pp. 636-641 CrossRef
- McHutchison, JG, Everson, GT, Gordon, SC (2009) Telaprevir with peginterferon and ribavirin for chronic HCV genotype 1 infection. N Engl J Med 360: pp. 1827-1838 CrossRef
- Hézode, C, Forestier, N, Dusheiko, G (2009) Telaprevir and peginterferon with or without ribavirin for chronic HCV infection. N Engl J Med 360: pp. 1839-1845 CrossRef
- Kwo PY, Lawitz EJ, McCone J, Schiff ER, et al. Efficacy of boceprevir, an NS3 protease inhibitor, in combination with peginterferon alfa-2b and ribavirin in treatment-naive patients with genotype 1 hepatitis C infection (SPRINT-1): an open-label, randomised, multicentre phase 2 trial. Lancet. 2010 28;376(9742):705–716.
- McHutchison, JG, Manns, MP, Muir, AJ (2010) Telaprevir for previously treated chronic HCV infection. N Engl J Med 362: pp. 1292-1303 CrossRef
- Sarrazin, C, Zeuzem, S (2010) Resistance to direct antiviral agents in patients with hepatitis C virus infection. Gastroenterology 138: pp. 447-462 CrossRef
- Sarrazin, C, Kieffer, TL, Bartels, D (2007) Dynamic hepatitis C virus genotypic and phenotypic changes in patients treated with the protease inhibitor telaprevir. Gastroenterology 132: pp. 1767-1777 CrossRef
- Source: Prescriber Profiler™ December 2008-November 2009, IMS Health Incorporated. All rights reserved.
- Direct-Acting Antiviral Therapy for Hepatitis C: Attitudes Regarding Future Use
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Digestive Diseases and Sciences
Volume 56, Issue 5 , pp 1509-1515
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Hepatitis C
- STAT C
- Direct-acting antiviral therapy
- Industry Sectors