Regional disparities in interferon therapy for chronic hepatitis C in Japan: a nationwide retrospective cohort study.

摘要: Many patients with chronic hepatitis C have been treated interferon (IFN) therapy in Japan, especially after the introduction of subsidies for medical expenses 2008. However, its performance and outcome never evaluated. Therefore, a nationwide, mail-based, retrospective cohort study was conducted. Regional disparities demographic features, treatment performance, virological response were evaluated using an intent-to-treat design. The participating prefectures classified into nine regions from north to south (Hokkaido/Tohoku, Kanto, Shin-etsu, Hokuriku, Tokai, Kinki, Chugoku, Shikoku, Kyushu). Multivariate logistic regression analysis performed select predictive factors outcome. From December 2009 May 2013, 16,854 registered 37 Japan (median age: 60 years; 50.4 % male; 74.8 % IFN-naive; HCV genotype [1 or 2]/viral load [high (≥5 log IU/mL) low (<5 IU/mL)]: 1/high = 58.2 %, 1/low = 5.2 %, 2/high = 27.3 %, 2/low = 7.5 %; 83.4 % peginterferon-α ribavirin). Mean age, proportion elderly (≥65 years), male sex, IFN-experienced, significantly different among (all P < 0.001). independently selected as one ribavirin, which revealed two that required further investigation. still exist IFN therapy, are strongly associated Since accessibility resources individual seemed be regions, public health actions should focused on how construct properly manage consultation networks between base hospitals local clinics, those population density.