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Recent HCV patients show more complications than decades prior

According to data from a retrospective study, researchers from the University of Michigan Health System found that patients with hepatitis C virus infection treated in 2011 and 2012 had more advanced liver disease vs. patients seen in 1998 and 1999.

“To prepare for the launch of interferon-free regimens, we examined the characteristics of hepatitis C patients newly referred to our liver clinics in 2011/2012 and compared them with patients seen in 1998/1999,” the researcher wrote. “We hypothesized that compared to the 1990s, HCV patients seen in recent years are older, have more advanced liver disease, are more likely to be treatment experienced and are enriched for HCV genotypes and sub genotypes that are more refractory to treatment.”

Data from 1,348 adult patients with HCV seen at the University of Michigan Health System in 1998/1999 (Era 1) and 2011/2012 (Era 2) were collected and analyzed via ICD-9 codes. Overall, 538 patients were included for analysis in Era 1 and 810 were seen in Era 2.

Analyses showed that compared to patients in Era 1, patients in Era 2 were older (P < .001) and of other races than Caucasian (P = .003). In addition, the median interval between diagnosis and evaluation was 4 years in Era 1 compared with 2 years in Era 2 (P < .001). More patients diagnosed with advanced liver disease, such as compensated or decompensated cirrhosis or hepatocellular carcinoma, were found in Era 2 compared with patients in the Era 1 group (61.6% vs. 51.5%; P < .001). More patients in Era 2 were treatment experienced compared with Era 1.

“There were few unexpected findings,” the researchers wrote.

Researchers also found HCV genotype 1 to be prevalent in 43.7% of patients in Era 2 compared with 21.7% in Era 1.

“Our finding is important because while some direct-acting antivirals have pan-genotype activity, others have lower barrier to resistance with genotype 1a HCV and lower sustained virologic response rate, and some DAA combination therapies are developed for patients with genotype 1b infection only,” the researchers wrote.

The researchers concluded: “Reduction in HCV disease burden will require development of treatment regimens targeted towards patients in the current Era …, improvement in early diagnosis and referral of infected patients to appropriate centers for treatment, and reduction in costs of newly approved DAAs; otherwise, implementation of screening programs and availability of highly efficacious treatment regimens will have little impact on disease burden.” – by Melinda Stevens

Disclosures: Talaat reports no relevant financial disclosures. Please see the study for a full list of all other authors’ relevant financial disclosures.