Tapan and Sertoglu
Letter to the Editor
DOI:10.1111/liv.12752 Liver Int. 2015; 35: 1775
Barriers to care and treatment for patients with chronic viral hepatitis in Europe: a systematic review To the Editor: We have read with great interest the article recently published by Papatheodoridis et al. (1). In this review, they summarize the most important barriers for an adequate management of HBV and HCV infection in Europe. Focusing on HCV infection, the main results involve viremic HCV-patients who are not treated, a mean proportion of 57% with a range between 52% and 89%. Different circumstances are pointed out to be responsible of the absence of a correct management, including economic difficulties in some countries and direct or indirect limitations because of interferon adverse events and toxic drug abuse. Probably our study, published on April in Liver International (2), could not be considered by Papatheodoridis et al.(1) because of frame time selection. Nevertheless, we would like to remark some characteristics of our series, a prospective and multicenter cohort which included 16 Spanish Hospitals, which we consider complementary to those described by Papatheodoridis and collaborators: (i) To our knowledge, our study was the first to focus on the barriers to HCV treatment in European patients in triple therapy (TT) era. (ii) In contrast opinion to (1), we believe that economic restriction is one of the most important reasons not to initiate treatment in Occidental European countries like Spain. Therefore, some Health policies prioritized the TT treatment (and probably this will occur with the newest Direct Acting Antivirals-DAA) in patients with advanced fibrosis (F3/F4), vs. patients with moderate (F2) and mild fibrosis (
Letter to the Editor
DOI:10.1111/liv.12752 Liver Int. 2015; 35: 1775
Barriers to care and treatment for patients with chronic viral hepatitis in Europe: a systematic review To the Editor: We have read with great interest the article recently published by Papatheodoridis et al. (1). In this review, they summarize the most important barriers for an adequate management of HBV and HCV infection in Europe. Focusing on HCV infection, the main results involve viremic HCV-patients who are not treated, a mean proportion of 57% with a range between 52% and 89%. Different circumstances are pointed out to be responsible of the absence of a correct management, including economic difficulties in some countries and direct or indirect limitations because of interferon adverse events and toxic drug abuse. Probably our study, published on April in Liver International (2), could not be considered by Papatheodoridis et al.(1) because of frame time selection. Nevertheless, we would like to remark some characteristics of our series, a prospective and multicenter cohort which included 16 Spanish Hospitals, which we consider complementary to those described by Papatheodoridis and collaborators: (i) To our knowledge, our study was the first to focus on the barriers to HCV treatment in European patients in triple therapy (TT) era. (ii) In contrast opinion to (1), we believe that economic restriction is one of the most important reasons not to initiate treatment in Occidental European countries like Spain. Therefore, some Health policies prioritized the TT treatment (and probably this will occur with the newest Direct Acting Antivirals-DAA) in patients with advanced fibrosis (F3/F4), vs. patients with moderate (F2) and mild fibrosis (
