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©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2008; 14(40): 6195-6203
Published online Oct 28, 2008. doi: 10.3748/wjg.14.6195
Patient education improves adherence to peg-interferon and ribavirin in chronic genotype 2 or 3 hepatitis C virus infection: A prospective, real-life, observational study
Patrice Cacoub, Denis Ouzan, Pascal Melin, Jean-Philippe Lang, Michel Rotily, Thierry Fontanges, Marina Varastet, Michel Chousterman, Patrick Marcellin
Patrice Cacoub, Department of Internal Medicine, Pitié-Salpêtrière Hospital, AP HP, Paris 75651, France; Pierre and Marie Curie (Paris 6) University, CNRS UMR 7087, Paris 75651, France
Denis Ouzan, Department of Hepato-Gastroenterology, Arnault Tzanck Institute, Saint Laurent du Var 06721, France
Pascal Melin, Department of Polyvalent Medicine, Hospital of Saint Dizier, Saint Dizier 52115, France
Jean-Philippe Lang, Department of Psychiatry and Addiction, Hospital of Erstein, Erstein 67152, France
Michel Rotily, Marina Varastet, ClinSearch, Bagneux 92220, France
Thierry Fontanges, Department of Hepato-Gastroenterology, General Hospital of Bourgoin, Bourgoin Jailleu 38317, France
Michel Chousterman, Department of Hepato-Gastroentrology, Hospital of Créteil (CHIC), Créteil 94010, France
Patrick Marcellin, Department of Hepatology, Beaujon Hospital, Pôle des Maladies de l'Appareil Digestif, Clichy 92118, France; and INSERM U 773, CRB3, University of Paris VII, Beaujon Hospital, Clichy 92118, France
Author contributions: Cacoub P, Ouzan D, Melin P, Lang JP, Rotily M, Fontanges T, Chousterman M, and Marcellin P (The Scientific Committee) designed the research, reviewed the data, supervised the analysis and interpreted the results; Varastet M helped analysing the data, interpreting the results, and wrote the paper; All authors helped writing, critically reviewed and approved the paper.
Supported by Schering-Plough France
Correspondence to: Patrice Cacoub, Professor, Department of Internal Medicine, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, Paris cedex 13 F-75651, France. patrice.cacoub@psl.aphp.fr
Telephone: +33-142-178027 Fax: +33-142-178033
Received: June 19, 2008
Revised: September 16, 2008
Accepted: September 23, 2008
Published online: October 28, 2008
AIM: To evaluate the impact of therapeutic education on adherence to antiviral treatment and sustained virological response (SVR) in a real-life setting in genotype 2/3 hepatitis C, as there are few adherence data in genotype 2/3 infection, even from randomized trials.
METHODS: This prospective survey included genotype 2/3 patients who received peg-interferon alfa-2b and ribavirin. There was no intervention. Adherence was self-reported over the past 4 wk (peg-interferon) or 7 d (ribavirin). Adherence to bitherapy was defined as adherence to the two drugs for ≥ 20 wk. SVR was defined as undetectable RNA ≥ 12wk after the end of treatment.
RESULTS: 370/674 patients received education during the first 3 mo of treatment. After 6 mo, adherence to bitherapy was higher in educated patients (61% vs 47%, P = 0.01). Adherence to peg-interferon was 78% vs 69% (P = 0.06). Adherence to ribavirin was 70% vs 56% (P = 0.006). The SVR (77% vs 70%, P = 0.05) and relapse (10% vs 16%, P = 0.09) rates tended to be improved. After adjustment for baseline differences, education improved adherence [Odds ratio (OR) 1.58, P = 0.04] but not the SVR (OR 1.54, P = 0.06).
CONCLUSION: In genotype 2/3 patients, therapeutic education helped maintain real-life adherence to bitherapy.
