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Health care rates, costs high in HCV/HIV patients who failed prior treatment

In a retrospective cohort study, patients with HCV/HIV co-infection with mild infection who did not achieve sustained virologic response from previous therapy for HCV had higher health care rates and costs 5 years post-treatment, according to published findings.

“This study was the first to compare the impact of successful HCV treatment on health care utilization in a HIV/HCV co-infected population with mild disease,” Graham S. Cooke, PhD, of the department of medicine at Imperial College London, and colleagues wrote. “Our results show significant differences in health care costs and utilization rates between individuals that are successfully treated for HCV compared to those failing treatment, despite the fact that they remain in secondary care.”

Graham S. Cooke

Researchers analyzed electronic records of 63 patients with HCV/HIV co-infection without evidence of fibrosis or cirrhosis who received HCV treatment with pegylated interferon and ribavirin with or without a protease inhibitor for a minimum of 3 months at a study center between 2004 and 2013. Of these, 76.2% achieved sustained virologic response at 12 weeks (n = 48) and 58% had evidence of acute infection (n = 28).

Conducting a detailed analysis of health care utilization up to 5 years following therapy using clinical and electronic records, the researchers were able to determine that patients who achieved SVR12 had lower health utilization rates (5,000 euros per patient) compared with patients who did not achieve SVR12 5 years post-treatment (10,775 euros per patient). These were rates based on five of nine measured health care services: clinician visits, hospital admissions, fibroscans and outpatient visits and ultrasound scans.

Further analyses showed varied services between the patients who met SVR12 and those who failed. For example, outpatient visits were higher in patients who did not meet SVR12 (3.3 visits per year) compared with patients who met SVR12 (1.5 per year; P = .0022). Those who failed SVR12 were more likely to undergo fibroscan or ultrasound compared with those who met SVR12, 5 years post-treatment (P < .0001).

“There was an associated increase in relative risk with the use of all listed healthcare services in the absence of SVR; however, results for hospital admissions and [emergency department] visits did not prove statistically significant,” the researchers wrote.

The researchers concluded: “The study found that within an HIV/HCV co-infected population with mild disease, unsuccessful treatment is associated with significantly higher costs, [more specifically 1,155 euros per year], of healthcare utilization per patient following HCV therapy than those who were successfully treated.” – by Melinda Stevens

Disclosure: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.