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Health care rates, costs high in HCV/HIV patients who fail treatment
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Patients with hepatitis C virus infection/HIV coinfection with mild disease who did not achieve sustained virologic response from previous therapy for HCV had greater health care utilization and costs 5 years after treatment, according to findings published in the Journal of Viral Hepatology.
“This study was the first to compare the impact of successful HCV treatment on health care utilization in a HIV/HCV coinfected 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 who are successfully treated for HCV compared to those failing treatment, despite the fact that they remain in secondary care.”
Cooke and colleagues conducted a retrospective cohort study of 63 patients with HCV/HIV coinfection 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 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 after treatment (10,775 euros per patient). These were rates based on five of nine measured health care services: clinician visits, hospital admissions, FibroScans, outpatient visits and ultrasound scans.
Further analyses showed that services varied between patients who met SVR12 and those who failed therapy. For example, outpatient visits were higher in patients who did not meet SVR12 (3.3 visits per year) compared with patients who did (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 after treatment (P < .0001).
“There was an associated increase in relative risk with the use of all listed health care services in the absence of SVR; however, results for hospital admissions and [ED] visits did not prove statistically significant,” the researchers wrote. – by Melinda Stevens
- Reference:
- Padam P, et al. J Viral Hepat. 2016;doi:10.1111/jvh.12484.
Disclosure: The researchers report no relevant financial disclosures.