Adherence to Hepatitis C Virus Therapy and Early Virologic Outcomes

Background.Suboptimal drug exposure attributable to physician-directed dosage reductions of pegylated interferon and/or ribavirin are associated with decreased sustained virologic response rates. However, data are limited with regard to suboptimal drug exposure that is attributable to missed doses b...

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Published in:Clinical infectious diseases 2009-01, Vol.48 (2), p.186-193
Main Authors: Lo Re, Vincent, Amorosa, Valerianna K., Localio, A. Russell, O'Flynn, Rose, Teal, Valerie, Stein, Zachariah Dorey, Kostman, Jay R., Gross, Robert
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Articles and Commentaries
Biological and medical sciences
Chronic hepatitis
Clinical outcomes
Cohort Studies
Dosage
Drug prescriptions
Drug therapy
Female
Genotypes
Health outcomes
Hepatitis
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Human viral diseases
Humans
Infections
Infectious diseases
Interferon alpha-2
Interferon-alpha - therapeutic use
Male
Medical sciences
Medication Adherence
Medications
Middle Aged
Pharmacies
Polyethylene Glycols
Proteins
Recombinant Proteins
Regression Analysis
Ribavirin - therapeutic use
Time Factors
Treatment Outcome
Viral diseases
Viral hepatitis
Viral Load
Virology
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Summary:Background.Suboptimal drug exposure attributable to physician-directed dosage reductions of pegylated interferon and/or ribavirin are associated with decreased sustained virologic response rates. However, data are limited with regard to suboptimal drug exposure that is attributable to missed doses by patients with chronic hepatitis C virus (HCV) infection. We examined the relationship between adherence to pegylated interferon and ribavirin therapy, measured by pharmacy refill, and HCV suppression during the initial 12 weeks of therapy. Methods.We conducted a cohort study involving 188 patients with chronic HCV infection who were treated with pegylated interferon plus ribavirin. Adherence was calculated using pharmacy refill data and could exceed 100%. The primary outcome was decrease in HCV load at 12 weeks; early virologic response was a secondary outcome. Mixed-effects regression models estimated the association between adherence and HCV suppression during the initial 12 weeks. Subanalyses were performed among patients who received optimal weight-based dosages. Results.The mean decrease in HCV load at 12 weeks was 0.66 log IU/mL greater for patients with ⩾85% adherence than for those with
ISSN:1058-4838
1537-6591
DOI:10.1086/595685