[Adherence to pegylated combination therapy in patients with chronic hepatitis C. Importance of the hepatologist, general practitioner, and nurse]

Gastroenterol Clin Biol. 2008 Mar;32(3 Pt 2):S96-S108. doi: 10.1016/S0399-8320(08)73272-X.
[Article in French]

Abstract

Adhesion to pegylated combination therapy is a key factor for therapeutic success in patients HCV infected. To optimize it, goals to reach are to limit dose reduction and premature discontinuation of treatment due to adverse events ; to improve the patient compliance to treatment, particularly during the first three months, particularly to ribavirin. Therapeutic education, management of psychiatric adverse events, epoetin alfa, have demonstrated their benefit in terms of sustained virologic response or quality of life. Preparing the treatment with the patient and a multi-disciplinary team, setting successive therapeutic goals with the predictive value of the early virologic response will promote adhesion to treatment. A hepatitis C training program for general practitioners (GP) allows an efficient follow-up of treated patients by a trio hepatologist - GP - nurse and a concrete implication of GP in the field of hepatitis C. Further developments are needed for : taking in account the patient quality of life during treatment to anticipate premature discontinuation, promotion of therapeutic education by specialized nurses, standardization of the diagnosis of depression during treatment, and regular updating of general practitioners on antiviral C treatment.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Drug Therapy, Combination
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use
  • Patient Care Team*
  • Patient Compliance
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins
  • Ribavirin / therapeutic use

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2b
  • peginterferon alfa-2a