Life expectancy improves for HCV patients in interferon-free era
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Study findings from California showed that life expectancy at age 20 years increased by almost 2 years among patients infected with hepatitis C virus between the interferon treatment and the interferon-free era, although researchers reported that the increase was not statistically significant. However, data showed life expectancy gains for some subgroups, including Hispanics.
“Although the increase in life expectancy we observed for people with HCV was not statistically significant overall, we included people with HCV in each treatment era regardless of whether they received treatment,” Julia Marcus, PhD, MPH, assistant professor of population medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, told Healio. “We expect to see larger gains in life expectancy among people with HCV in future studies as direct acting antiviral (DAA) use becomes more widespread.”
Marcus and colleagues analyzed clinical data on 25,291 patients with HCV and 4,921,830 patients without HCV who were members of the Kaiser Permanente Northern California health care system. They observed a 0.3-year (95% CI, 0.2-0.3) increase in life expectancy from 63.4 to 63.6 years among individuals without HCV from the interferon (2007-2014) to interferon-free (2015-2017) era, and a 1.8-year increase (95% CI, –1 to 4.7) from 49.3 years to 51.1 years in life expectancy among HCV patients. The gap in life expectancy between individuals with and without HCV narrowed from 14.1 years to 12.5 years between the two eras.
Data showed that life expectancy increased 6.6 years (95% CI, 2.3-10.9) among Hispanics, 5.9 years (95% CI, –2.7 to 14.4) among Asians, 4.8 years (95% CI, –3.3 to 13.1) among non-Hispanic blacks, and 0.4 years (95% Cl: –3.8 to 4.7) among non-Hispanic whites.
Marcus said she was surprised to find the largest increases in life expectancy for patients with HCV were from racial and ethnic minority backgrounds, and that there was virtually no increase in the white subgroup.
“We thought this may reflect a narrowing of racial and ethnic disparities in HCV treatment initiation and outcomes in the DAA era,” Marcus said. “The lack of improvement in life expectancy for white people with HCV might also reflect the impact of the opioid epidemic during this same time period.”
Marcus emphasized the positive effect that DAAs have had on the speed of treatment for HCV patients.
“DAAs have revolutionized HCV care,” Marcus said. “Interferon-based regimens were toxic, required injections over the course of a year, and had relatively low cure rates, especially for people with advanced liver disease and HIV coinfection. The switch to interferon-free regimens has meant that almost all people with HCV can now be treated in 8 to 12 weeks with minimal side effects.” – by Eamon Dreisbach
Disclosures: Marcus reports consulting for Kaiser Permanente Northern California on a research grant from Gilead Sciences unrelated to this study. Please see the full study for the other authors’ relevant financial disclosures.
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