| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000411379 |
| ISSN: | 1665-2681 |
| Authors: | Schaeffer, Sarah1 Khalili, Mandana1 |
| Institutions: | 1University of California at San Francisco, San Francisco General Hospital, San Francisco, California. Estados Unidos de América |
| Year: | 2015 |
| Season: | Mar-Abr |
| Volumen: | 14 |
| Number: | 2 |
| Pages: | 234-242 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | African Americans are disproportionately affected by hepatitis C (HCV) and are less likely to undergo HCV treatment. Underserved populations are especially at risk for experiencing health disparity. Aim. To identify reasons for HCV non-treatment among underserved African Americans in a large safetynet system. Material and methods. Medical records of HCV-infected African Americans evaluated at San Francisco General Hospital liver specialty clinic from 2006-2011 who did not receive HCV treatment were reviewed. Treatment eligibility and reasons for non-treatment were assessed. Factors associated with treatment ineligibility were assessed using logistic regression modeling. Results. Among 118 patients, 42% were treatment ineligible, 18% treatment eligible, and 40% were undergoing work-up to determine eligibility. Reasons for treatment ineligibility were medical (54%), non-medical (14%), psychiatric (4%), or combined (28%). When controlling for age and sex, active/recent substance abuse (OR 6.65, p = 0.001) and having two or more medical comorbidities (OR 3.39, p = 0.005) predicted treatment ineligibility. Excluding those ineligible for treatment, 72% of all other patients were lost to follow-up; they were older (55 vs. 48 years, p = 0.01) and more likely to be undergoing work up to determine treatment eligibility (86 vs. 21%, p < 0.0001) than those not lost to follow-up. Conclusions. Medical comorbidities and substance abuse predicted HCV treatment ineligibility in underserved African Americans. Importantly, the majority of those undergoing work-up to determine HCV treatment eligibility were lost to follow-up. While newer anti-HCV agents may increase treatment eligibility, culturally appropriate interventions to increase compliance with evaluation and care remain critical to HCV management in underserved African Americans |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Terapéutica y rehabilitación, Hepatitis C, Variación racial, Interferón, Afroamericanos |
| Keyword: | Medicine, Gastroenterology, Therapeutics and rehabilitation, Hepatitis C, Ratial variation, Interferon, Afroamericans |
| Full text: | Texto completo (Ver PDF) |
