BACKGROUND & AIMS: Despite the availability of effective therapies for hepatitis B (HBV) and C virus (HCV), only a minority of these patients receive treatment. We systematically reviewed published data on barriers to management for chronic HBV/HCV patients in Europe. METHODS: Literature search to identify studies including adult patients with chronic HBV/HCV infection from European countries and data on barriers to treatment. RESULTS: Twenty-five studies including 6253 chronic HBV and 19,014 HCV patients were identified, of which only two were from Eastern Europe. The mean rate of no treatment in HBV patients was 42% being higher in North-Western European countries than Italy (56% vs. 39%, P < 0.001). Immigrants represented the most common barrier to HBV treatment. The mean rate of no treatment in HCV RNA-positive patients was 57%, being highest in Romania (89%), intermediate in France (79%) and lower though still high in other European countries (52%, P < 0.001). The predominant barriers to HCV treatment were lack of financial resources in Romania and direct/indirect limitations of interferon-alfa and/or parenteral drug and alcohol abuse in other countries. The mean rate of no treatment was highest in HCV RNA-positive parenteral drug users (72%) and intermediate in those with HCV-HIV co-infection (64%). CONCLUSIONS: A substantial proportion of diagnosed chronic HBV and the majority of diagnosed HCV patients remain untreated. The rates and most importantly the reasons of barriers to treatment in chronic HBV/HCV patients vary widely among European countries supporting the need for country-specific national strategies, resource allocation and implementation of global management policies.
BACKGROUND & AIMS: Despite the availability of effective therapies for hepatitis B (HBV) and C virus (HCV), only a minority of these patients receive treatment. We systematically reviewed published data on barriers to management for chronic HBV/HCV patients in Europe. METHODS: Literature search to identify studies including adult patients with chronic HBV/HCV infection from European countries and data on barriers to treatment. RESULTS: Twenty-five studies including 6253 chronic HBV and 19,014 HCV patients were identified, of which only two were from Eastern Europe. The mean rate of no treatment in HBV patients was 42% being higher in North-Western European countries than Italy (56% vs. 39%, P < 0.001). Immigrants represented the most common barrier to HBV treatment. The mean rate of no treatment in HCV RNA-positive patients was 57%, being highest in Romania (89%), intermediate in France (79%) and lower though still high in other European countries (52%, P < 0.001). The predominant barriers to HCV treatment were lack of financial resources in Romania and direct/indirect limitations of interferon-alfa and/or parenteral drug and alcohol abuse in other countries. The mean rate of no treatment was highest in HCV RNA-positive parenteral drug users (72%) and intermediate in those with HCV-HIV co-infection (64%). CONCLUSIONS: A substantial proportion of diagnosed chronic HBV and the majority of diagnosed HCV patients remain untreated. The rates and most importantly the reasons of barriers to treatment in chronic HBV/HCV patients vary widely among European countries supporting the need for country-specific national strategies, resource allocation and implementation of global management policies.
Authors: Keith C K Lau; Abdel Aziz Shaheen; Alexander A Aspinall; Tazuko Ricento Ba; Kamran Qureshi Mba; Stephen E Congly; Meredith A Borman; Saumya Jayakumar; Bertus Eksteen; Samuel S Lee; Laura Stinton; Mark G Swain; Kelly W Burak; Carla S Coffin Journal: CMAJ Open Date: 2017-06-06
Authors: Carissa E Chu; Feng Wu; Xi He; Kali Zhou; Yu Cheng; Weiping Cai; Elvin Geng; Paul Volberding; Joseph D Tucker Journal: Open Forum Infect Dis Date: 2016-06-24 Impact factor: 3.835
Authors: Soraia Mafra Machado; Cesar de Almeida; João Renato Rebello Pinho; Fernanda de Mello Malta; Ligia Capuani; Aléia Faustina Campos; Fatima Regina Marques Abreu; Ana Catharina de Seixas Santos Nastri; Rúbia Anita Ferraz Santana; Ester Cerdeira Sabino; Maria Cássia Mendes-Correa Journal: Rev Saude Publica Date: 2017-04-27 Impact factor: 2.106
Authors: Vinh D Vu; Ailinh Do; Nghia H Nguyen; Lily H Kim; Huy N Trinh; Huy A Nguyen; Khanh K Nguyen; My Nguyen; Andrew Huynh; Mindie H Nguyen Journal: BMJ Open Gastroenterol Date: 2015-10-21