Collaboration between Hepatologists and Primary Care Physicians in Treating Patients with Chronic Hepatitis C
10.2185/jrm.6.54
- Author:
Junichi Tazawa
;
Yoshinori Sakai
;
Fumihiko Kusano
;
Kazuyoshi Nagayama
;
Hideomi Fujiwara
- Publication Type:Journal Article
- Keywords:
chronic hepatitis C;
peginterferon;
ribavirin;
primary care physician;
collaboration
- From:Journal of Rural Medicine
2011;6(2):54-59
- CountryJapan
- Language:English
-
Abstract:
Objective: The purpose of this study was to assess the treatment outcome in patients with chronic hepatitis C (CHC) using the current standard antiviral therapy when patient were treated in collaboration between hepatologists and primary care physicians (PCPs).Patients and Methods: One hundred and ten patients with CHC were treated with a combination therapy of peginterferon-alpha 2b and ribavirin. Among them, 25 patients were treated by a collaboration between hepatologists and PCPs (collaboration group), whereas 85 patients were treated with exclusively by hepatologists (noncollaboration group). The duration of the therapy was 48 weeks for 58 'difficult- to-treat' patients (genotype 1 with a high load of HCV-RNA; 1H patients) and 24 weeks for the remaining 52 patients (non-1H patients). In the collaboration group, antiviral therapy was initiated and adjusted, if needed, by hepatologists (visits every four weeks), whereas the weekly administration of peginterferon-alpha 2b was performed by PCPs. Clinical characteristics and the treatment outcome were compared between these two groups.Results: The two groups had similar baseline characteristics. By intention to treat, the two groups showed similar rates of treatment-related serious adverse effects (0% vs. 1%, respectively) and dropout rates for adverse effects (8% vs. 13%, respectively). Sustained virologic response rates were also similar between the two groups, being 42% vs. 39% in the 58 1H patients (NS) and 62% vs. 64% in the 52 non-1H patients (NS), respectively.Conclusions: Collaboration between hepatologists and PCPs may be a valid treatment alternative to treat patients with CHC using the current standard antiviral therapy.
