A Study to Understand the Reasons for Early Treatment Discontinuation among People Living with Hepatitis C in Punjab, India

Abstract

Background: Punjab, India’s public sector hepatitis C virus (HCV) program has initiated >60,000 patients on free-of-cost treatment. However, >10% of patients initiated but did not complete treatment. Objective: To assess reasons for early HCV treatment discontinuation in Punjab, India. Materials and Methods: Telephonic interviews were conducted among 475 people living with HCV who discontinued HCV treatment (2018–2019) to identify primary self-reported reasons for treatment discontinuation. Results: Eighty-nine percent of respondents were male; 59% were aged 18–35 years. The leading reasons for treatment discontinuation were feeling better/well (24%), relocation (20%), and lack of time to visit the facility due to work or personal obligations (15%). Limited awareness about HCV and poor counseling emerged as prominent root causes for many of the reasons cited. Seventy-eight percent of the respondents were not counseled on the importance of treatment completion, and 63% were not aware that HCV treatment discontinuation can have health consequences. Conclusion: This study has revealed that there is a strong need to improve counseling for HCV in Punjab, given that many participants did not understand the importance of completing HCV treatment despite the resolution of symptoms and feeling well. Interventions such as refresher trainings and enhanced counseling materials, better support of patient transfers across facilities, and multimonth dispensations may help to improve retention in care.

Keywords

• attrition
• counseling
• hepatitis c
• india
• loss to follow-up
• patient