Original scientific paper
Treatment of chronic hepatitis C in Croatian war veterans: experiences from Croatian reference center for viral hepatitis
Neven Papić
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Snježana Židovec Lepej
; Department of Molecular Diagnostics and Cellular Immunity University Hospital for Infectious Diseases, Zagreb, Croatia
Ivan Kurelac
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Vjeran Čajić
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Jelena Budimir
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Davorka Dušek
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Adriana Vince
; Department of Viral Hepatitis, University Hospital for Infectious Diseases, Zagreb, Croatia
Abstract
Aim To examine the risk factors, comorbidity, severity of
liver disease, treatment course, and outcome in Croatian
war veterans with chronic hepatitis C, especially those suffering
from posttraumatic stress disorder (PTSD).
Methods We collected medical records of 170 adult men
diagnosed with chronic hepatitis C who started treatment
with a combination of pegylated interferon-alpha and ribavirin
between January 2003 and June 2009 at the Croatian
Reference Centre for Viral Hepatitis.
Results Participants’ mean age was 43 ± 9 years. Among
170 participants, there were 37 war veterans (22%). The
main risk factor in veteran patients were operative procedures
with transfusions (46% vs 5% in non-veterans;
P < 0.001) and in non-veteran patients intravenous drug
use (42.1% vs 13%; P < 0.001). The average duration of infection
was longer in war veterans (14.5 ± 3.4 vs 12.2 ± 7.2
years; P = 0.020). The percentage of PTSD comorbidity in
the whole group was 11% (18/170) and in the war veterans
group 49% (18/37). The prevalence of sustained virological
response in patients with PTSD was 50% and in patients
without PTSD 56%. Treatment reduction in patients
with PTSD (33%) was higher than in patients without PTSD
(12%; P = 0.030).
Conclusion Croatian war veterans are a group with high
risk of chronic hepatitis C infection because many of them
were wounded during the Croatian War 1991-1995. Considerations
about PTSD as a contraindication for interferon
treatment are unjustified. If treated, patients with PTSD
have an equal chance of achieving sustained virological response
as patients without PTSD.
Keywords
Chronic hepatitis C; hepatitis C; HCV; war veterans; PTSD; pegylated interferon; SVR; Croatian War for Independence
Hrčak ID:
78189
URI
Publication date:
15.2.2011.
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