Patient education improves adherence to peg-interferon and ribavirin in chronic genotype 2 or 3 hepatitis C virus infection: A prospective, real-life, observational study

Table 1 Baseline characteristics of the patients (n = 674): Univariate analysis

	Therapeutic education
	No (n = 304)	Yes (n = 370)	P
Socio-demography
Men	170/303 (56)	229/370 (62)	0.14
Age (yr)	44.1 ± 11.4	44.9 ± 11.4	0.16
Body mass index (kg/m2)	23.5 ± 4.1	24.1 ± 4.2	0.06
Employment status
Professional activity	190/303 (63)	220/370 (59)	0.59
Unemployed	48/303 (16)	69/370 (19)
Other	65/303 (22)	81/370 (22)
Educational level
Low	182/300 (61)	223/365 (61)	0.94
High	118/300 (39)	142/365 (39)
Origin of incomes
Paid employment	166/298 (56)	183/368 (50)	0.24
Unemployment incomes	48/298 (16)	60/368 (16)
Other	84/298 (28)	125/368 (34)
Debts
Difficult to manage	8/232 (4)	27/315 (9)	0.02
None or easily managed	224/232 (97)	288/315 (91)
Comorbidities
Past psychiatric history
Depression	67/303 (22)	113/370 (31)	0.01
Suicide attempt	23/302 (8)	29/368 (8)	0.81
Hospitalisation for mental disease	25/301 (8)	36/369 (10)	0.59
Psychiatric disorder	60/300 (20)	98/367 (27)	0.04
Chronic disease	64/298 (22)	89/366 (24)	0.41
Risk factors
Alcohol consumption > 20 g/d	10/70 (14)	24/100(24)	0.17
Tobacco consumption	167/299 (56)	187/366 (51)	0.24
Drug abuse
None	139/303 (46)	172/368 (47)	0.02
Former	158/303 (52)	174/368 (47)
Current	6/303 (2)	22/368 (6)
HCV infection
Source of HCV infection1
Transfusion	62/304 (20)	76/370 (21)	1.00
Injection or intranasal drug abuse	157/304 (52)	193/370 (52)	0.94
Other	86/304 (29)	100/370 (27)	0.86
Duration of HCV infection year)	20.4 ± 8.4	20.0 ± 8.9	0.85
Serum HCV-RNA
≤ 800 000 IU/mL or equivalent	121/193 (63)	162/265 (61)	0.77
> 800 000 IU/mL or equivalent	72/193 (37)	103/265 (39)
HCV genotype
2	85/304 (28)	117/370 (32)	0.31
3	219/304 (72)	253/370 (68)	0.31
Coinfection
Human immunodeficiency virus	12/303 (4)	14/369 (4)	1.00
Hepatitis B virus2	3/301 (1)	6/369 (2)	0.63
Metavir activity grade or equivalent
A0 or A1	119/226 (53)	131/272 (48)	0.32
A2 or A3	107/226 (47)	141/272 (52)
Metavir fibrosis stage or equivalent
F0 or F1	110/227 (49)	109/272 (40)	0.04
F2 or F3	82/227 (36)	129/272 (47)
F4	35/227 (15)	34/272 (13)
Knodell score	7.9 ± 3.0	8.4 ± 3.5	0.19
Previous anti-HCV treatment course
None	242/303 (80)	303/370 (82)	0.74
One or more	61/303 (20)	67/370 (18)

Data are expressed as mean ± SD, or proportions of patients.

¹One patient could have more than one presumed source of infection.

²Hepatitis B antigen positivity.

Table 2 Treatment planned and actually received (n = 674): Univariate analysis

	Therapeutic education
	No (n = 304)	Yes (n = 370)	P
Duration of bitherapy (wk)1
Planned	27.7 ± 8.9	27.1 ± 8.2	0.49
Actual	28.4 ± 12.7	30.3 ± 14.2	0.25
Premature discontinuation (< 20 wk)	44/304 (15)	41/370 (11)	0.20
Peginterferon weekly dose (μg/kg)
Planned	1.35 ± 0.29	1.41 ± 0.22	0.01
Actual at 3 mo2	1.31 ± 0.30	1.38 ± 0.25	0.006
Actual at 6 mo2	1.18 ± 0.35	1.25 ± 0.31	0.02
Ribavirin daily dose (mg)
Planned	897 ± 147	906 ± 154	0.67
Actual at 3 mo2	871 ± 166	885 ± 175	0.25
Actual at 6 mo2	771 ± 201	803 ± 209	0.06

Data are expressed as mean ± SD, or proportions of patients.

¹Date of end of bitherapy minus date of inclusion;

²Cumulated over the past 3 mo (AUC, investigator report).

Table 3 Adherence to treatment, virological response (univariate analysis) and their association with therapeutic education (multivariate analysis)

	Therapeutic education
	Univariate analysis			Multivariate analysis
	No (n = 304)	Yes (n = 370)	P	OR	95% CI	P
Adherence1 at 3 mo
Bitherapy	137/218 (63)	164/250 (66)	0.56	1.04	0.69 to 1.56	0.87
Peginterferon	175/218 (80)	201/250 (80)	1.00	0.94	0.57 to 1.53	0.79
Ribavirin	152/218 (70)	186/250 (74)	0.30	1.13	0.72 to 1.77	0.59
Adherence1 at 6 mo
Bitherapy	83/175 (47)	126/208 (61)	0.01	1.58	1.02 to 2.46	0.04
Peginterferon	121/175 (69)	162/208 (78)	0.06	1.78	1.07 to 2.96	0.03
Ribavirin	98/175 (56)	145/208 (70)	0.006	1.67	1.05 to 2.65	0.03
Virological response2
SVR	171/246 (70)	230/298 (77)	0.05	1.543	0.99 to 2.40	0.06
Nonresponse	37/246 (15)	37/298 (12)	0.38
Relapse	38/246 (16)	31/298 (10)	0.09

Data are expressed as proportions of patients. Multivariate analyses were adjusted for sex, weight, BMI, educational level (adherence only), history of depression, psychiatric disorders, alcohol consumption, drug abuse, duration of HCV infection, previous anti-HCV treatment, HCV genotype (SVR only), and peginterferon dose prescribed at inclusion.

¹≥ 3 peginterferon injections during the last 4 wk and/or ≥ 22 ribavirin capsules of 200 mg each during the last 7 d (self-report);

²≥ 12 wk after the end of treatment;

³The rate of SVR was used as dependent variable.