PIN87 Hepatitis C Treatment Continuation Rates in Treatment-Naïve Genotype 1 Patients in the Brazilian Public Health Care System

Abstract

Determine real-life treatment continuation rates of chronic Hepatitis C (HCV) treatment from a database of medicine dispensation in the Brazilian public healthcare system. Monthly data from a public database of medicine dispensation was analyzed for a period of 17 months. The patient cohort was defined as all new HCV (CID10 B18.2) patients initiating treatment between January and December 2009. To identify HCV genotype 1 (G1) patients, it was assumed G1 patients initiated treatment with the pegylated forms of the interferons (pegIFN), as defined by the Brazillian national guidelines for HCV. Between January and December 2009, 10,992 patients began treatment for HCV. Around 58% of these patients were male with a median age of 49.7 years. Of these, 82% of patients (9,019) were considered G1 as they began treatment with pegIFN and/or ribavirin. Almost all patients (97%) began treatment with the treatment combination pegIFN and ribavirin, with an equal split among both brands of pegIFN. For all HCV patients treatment mean/median was 38,3/40 weeks compared to 40.2/44.0 weeks for G1 patients. At week 48, 63% of all HCV patients had discontinued treatment compared to 58% of G1 patients. At week 24, around 19% of all HCV patients had discontinued treatment compared to 18% of G1 patients. The maximum observed treatment duration was 85 weeks in both all HCV and G1 patients. Discontinuation rates before week 24 were similar between all HCV and G1 patients. Although 48 weeks of treatment is the established duration for G1 patients, the majority of patients discontinue treatment earlier. These data, however, do not guarantee patients actually receive treatment, as it follows medicine dispensation.