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Tangible Resources for Preparing Patients for Antiviral Therapy for Chronic Hepatitis C

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Abstract

Background

Chronic hepatitis C (HCV) infected patients with coexisting mental health and/or substance abuse issues face significant barriers to treatment and are often deferred. This paper sought to highlight critical pre-treatment strategies and provide tangible resources for HCV clinicians to facilitate preparation and successful treatment of these patients.

Methods

Guided by the clinical experience of our liver center, a large, tertiary academic medical center, and informed by the extant literature, we summarize pre-treatment strategies and specific resources and recommendations for HCV providers.

Results

Four key pre-treatment strategies include: 1) screening for mental health/substance abuse issues using brief, reliable and validated instruments; 2) locating and establishing collaborative care with mental health and substance abuse specialists; 3) using a motivational interviewing communication style; and 4) addressing adherence-related issues.

Conclusions

HCV clinicians are in a unique position to prepare patients with coexisting mental health and/or substance abuse issues for antiviral therapy.

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Abbreviations

MH/SA:

Mental health/substance abuse

HCV:

Chronic hepatitis C virus

SVR:

Sustained virological response

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Acknowledgements

Donna Evon receives research grant support from Roche, and served on an advisory board for Vertex Pharmaceuticals in the past 12 months. Michael Fried receives research grants from Genentech, Vertex, Tibotec, Janssen, Gilead, Abbott, Bristol-Myers Squibb, Anadys. Dr. Fried also serves as an ad hoc consultant to Genentech, Vertex, Merck, Tibotec, Janssen, Bristol-Myers Squibb, Novartis and Gilead. Sid Barritt is on the speaker's bureau for Salix Pharmaceuticals and receives research grant support from Tibotec. This work was supported, in part, by a UNC Clinical and Translational Science Award (UL1RR025747; Bonner); the National Institutes of Health Awards (1KL2-RR025746-03; Barritt; and K23DK089004-02; Evon) and a mentoring grant (K24 DK066144-01; Fried).

Conflict of interest

Dr. Bonner has nothing to disclose.

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Correspondence to Donna M. Evon.

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Bonner, J.E., Barritt, A.S., Fried, M.W. et al. Tangible Resources for Preparing Patients for Antiviral Therapy for Chronic Hepatitis C. Dig Dis Sci 57, 1439–1444 (2012). https://doi.org/10.1007/s10620-012-2142-3

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