Reasons for non‐treatment of hepatitis C in veterans in care

Summary.  We prospectively studied 354 patients with hepatitis C virus (HCV) infection who were referred to a hepatology specialty clinic to find the reasons for non‐treatment of HCV. The median age was 48 years (range 27–77 years), 98.5% were male and 71% were white. Seventy per cent of the patients were not treated. The most common reasons for non‐treatment were non‐adherence to follow‐up visit (24%), normal liver enzymes (14%), concurrent medical problems (11%), alcohol and drug use (9%), psychiatric problems (7%), advanced liver disease (7%), referral for transplant evaluation (6.4%) and patient refusal, transfer of care to another facility and non‐detectable HCV RNA levels (5% each). The reason was not recorded for 5% of the patients and was treatment deferred in 2.4% while waiting for pegylated interferon approval. Non‐treatment was more likely in patients with less than 12 years of education and a history of incarceration. Patients who were lost to follow‐up and refused treatment were more likely to have current alcohol and drug use and a history of incarceration.