Abstract

Purpose: To determine the influence of patient religiosity on the outcome of treatment of hepatitis C infection. Methods: A prospective, blinded, cohort study was performed on hepatitis C infected-patients. Patients were categorized as higher religiosity and lower religiosity based on responses to questions derived from a modification of the Multidimensional Religiosity/Spirituality Questionnaire. Comparisons were made between high and low religiosity patients (total and treated population) on demographics, pre-treatment lab values, and response to treatment with sustained viral clearance. Analysis on comparisons consisted of Pearsons chi-squared (or Fishers exact test) for ordinal outcomes and both the two-sample t-test and the Mann-Whitney two-sample statistic for score outcomes (mean and rank, respectively). Results: Eighty-seven of the 89 patients enrolled were recovered for analysis. The questionnaire results were used to place 38 (44%) in the higher religiosity cohort and 49 (56%) in the lower religiosity cohort. The patients (60% female) were ethnically diverse; African American 39%; Hispanic 31%; White 29%. African American race (59%) and female gender (74%) were associated with higher religiosity (p= 0.001, 0.026). Sixty-five (75%) patients were offered treatment with combination peginterferon and ribavirin therapy. Sixty-two agreed to begin treatment. Fifty-six patients (13 genotype 2 or 3; 42 genotype 1) completed the 24 or 48 week regimen. The frequency of being offered treatment, accepting treatment, and completing treatment were similar in both religiosity cohorts (p= 0.234, 0.809, 0.367). Thirty-one (55%) of those who completed treatment had negative HCV PCR 3–6 months after therapy. The sustained viral response was similar in the higher religiosity (50%) and lower religiosity (59%) cohorts (p= 0.517). Based on these sample sizes, post power analysis revealed only a 16% power to detect a difference between the proportions of 0.10. Conclusions: We were unable to demonstrate that patient-reported religiosity was statistically associated with the outcome of treatment of chronic HCV infection. This study was funded in part by the Frank Lanza Research Fund and Public Health Service grant DK56338, which funds the Texas Gulf Coast Digestive Diseases Center.

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