{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T14:27:15Z","timestamp":1781620035366,"version":"3.54.5"},"reference-count":53,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,5,16]],"date-time":"2014-05-16T00:00:00Z","timestamp":1400198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hepatitis B & C Public Policy Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Despite the availability of effective therapies for hepatitis B (<jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>) and C virus (<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>), only a minority of\u00a0these patients receive treatment. We systematically reviewed published data on barriers to management for chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> patients in Europe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Literature search to identify studies including adult patients with chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection from European countries and data on barriers to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five studies including 6253 chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> and 19\u00a0014 <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> patients were identified, of which only two were from Eastern Europe. The mean rate of no treatment in <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> patients was 42% being higher in North\u2010Western European countries than Italy (56% vs. 39%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Immigrants represented the most common barrier to <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> treatment. The mean rate of no treatment in <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content>\u2010positive patients was 57%, being highest in Romania (89%), intermediate in France (79%) and lower though still high in other European countries (52%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The predominant barriers to <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> treatment were lack of financial resources in Romania and direct\/indirect limitations of interferon\u2010alfa and\/or parenteral drug and alcohol abuse in other countries. The mean rate of no treatment was highest in <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content>\u2010positive parenteral drug users (72%) and intermediate in those with <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> co\u2010infection (64%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A substantial proportion of diagnosed chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> and the majority of diagnosed <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> patients remain untreated. The rates and most importantly the reasons of barriers to treatment in chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> patients vary widely among European countries supporting the need for country\u2010specific national strategies, resource allocation and implementation of global management policies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12565","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T07:41:10Z","timestamp":1398152470000},"page":"1452-1463","source":"Crossref","is-referenced-by-count":48,"title":["Barriers to care and treatment for patients with chronic viral hepatitis in Europe: a systematic review"],"prefix":"10.1111","volume":"34","author":[{"given":"George V.","family":"Papatheodoridis","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Athens University Medical School Laiko General Hospital of Athens Athens 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