Review article: adherence to medication for chronic hepatitis C – building on the model of human immunodeficiency virus antiretroviral adherence research

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Abstract
Summary: Background Treatment of hepatitis C virus (HCV) infection with pegylated interferon/ribavirin achieves sustained virological response in up to 56% of HCV mono‐infected patients and 40% of HCV/human immunodeficiency virus (HIV)‐co‐infected patients. The relationship of patient adherence to outcome warrants study.Aim To review comprehensively research on patient‐missed doses to HCV treatment and discuss applicable research from adherence to HIV antiretroviral therapy.Methods Publications were identified by PubMed searches using the keywords: adherence, compliance, hepatitis C virus, interferon and ribavirin.Results The term ‘non‐adherence’ differs in how it is used in the HCV from the HIV literature. In HCV, ‘non‐adherence’ refers primarily to dose reductions by the clinician and early treatment discontinuation. In contrast, in HIV, ‘non‐adherence’ refers primarily to patient‐missed doses. Few data have been published on the rates of missed dose adherence to pegylated interferon/ribavirin and its relationship to virological response.Conclusions As HCV treatment becomes more complex with new classes of agents, adherence will be increasingly important to treatment success as resistance mutations may develop with suboptimal dosing of HCV enzyme inhibitors. HIV adherence research can be applied to that on HCV to establish accurate methods to assess adherence, investigate determinants of non‐adherence and develop strategies to optimize adherence.