Do a significant proportion of subjects for whom interferon therapy is recommended not start therapy or comply with interferon therapy? If not, any idea why not? Is adherence or compliance with interferon therapy a significant health care issue? I would greatly appreciate any advice about social or behavioral predictors (models) for treatment compliance in HCV patients. -- Thanks, Joe

Doctors (and patients) have known for a long time that sticking to the treatment regimen is a predictor for success. Think about blood pressure medications, they'll only work if they're being taken as prescribed and are less effective sitting in the medicine cabinet! Recently, data from clinical trials indicates that maintaining compliance or adherence with interferon and ribavirin therapies (including pegylated interferon)for hepatitis C will greatly enhance the likelihood of sustained response.

Currently, there are no pretreatment predictors of compliance. We are just beginning to look at this question more closely in newer trials of hepatitis C therapy. However, all HCV-treating physicians are becoming aware of this issue and should be discussing the importance of maintaing adherence with their patients. This requires close cooperation between the patient, physician and other healthcare providers.