Contextual analysis of determinants of late Diagnosis of Hepatitis C Virus infection in medicare patients

Chirikov, Viktor; Shaya, FT; Howell, Charles D.

doi:10.1016/j.jval.2015.03.1444

Cited by 3 publications

(5 citation statements)

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“…Little is presently known about the patient factors associated with the timing of CLD diagnosis; only a handful of studies have explored this issue, and these have been limited to viral hepatitis 10,11 . Previous studies have only examined late diagnosis for patients with viral hepatitis related CLD, Thus far, the factors associated with late diagnosis in a community/primary care population -where most CLD cases are alcohol or non-alcoholic fatty liver disease (NAFLD) related 12 -are unclear.…”

Section: Authorsmentioning

confidence: 99%

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Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival

et al. 2020

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BACKGROUND: Chronic liver disease (CLD) is frequently diagnosed at a late stage when prognosis is poor. We aimed to determine the patient factors associated with a late CLD diagnosis and its subsequent impact on survival in order to support early diagnosis initiatives. METHODS: We identified participants of UK biobank (UKB) study who developed first-time advanced CLD within 5-years. We identified factors associated with late diagnosis via logistic regression, and used survival analysis to measure the association between late CLD diagnosis and mortality risk.RESULTS: 725 UKB participants developed first-time advanced CLD event within 5-years. 83% of cases were diagnosed late. Late diagnosis was associated with aetiology; the odds of late diagnosis were twelve times higher for an individual with alcohol-related liver disease (ArLD) versus viral hepatitis (aOR:12.01;p<0.001).Cumulative mortality 5-years after incident advanced CLD was 43.4% (95%CI:39.6-47.0). Late diagnosis was associated with a higher risk of post-advanced CLD mortality for patients with NAFLD (aHR:2.18; 95% CI:0.86-5.51; p=0.10), but not for other aetiologies.CONCLUSIONS: Late CLD diagnosis varies according to aetiology, and is highest for patients with ArLD and non-alcoholic fatty liver disease. The association between late diagnosis and postadvanced CLD mortality may also vary by aetiology.

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Section: Authorsmentioning

confidence: 99%

“…Previous studies have demonstrated that many patients do not receive a diagnosis of CLD until after the onset of advanced CLD 3,10,11,21 . Our current understanding of the determinants of this phenomenon remains limited, especially in the context of a community cohort.…”

Section: Main Findings Of This Studymentioning

confidence: 99%

Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival

et al. 2020

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“…For instance, alcohol abuse was the strongest predictor of advanced liver disease at initial HCV diagnosis in three U.S. Medicare cohorts. 40 Until the early years of DAA availability, AUD remained a barrier to HCV treatment uptake or a reason for deferring HCV treatment initiation. 41 This was partly due to some health care providers' concerns about heavy drinkers' ability to adhere to treatment.…”

Section: Effect Of Aud On Hcv Treatment Uptakementioning

confidence: 99%

Alcohol Use Disorder and Hepatitis C Prevention and Care in People Who Inject Drugs: The State of Play

et al. 2020

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Safe and effective treatment with direct-acting antivirals (DAAs) has ushered in an era in which hepatitis C virus (HCV) elimination, as set out by the World Health Organization, is possible. However, alcohol use disorder (AUD) has the potential to reduce the benefits of prevention interventions and reduce access to and continuity of HCV care in at-risk populations, such as people who inject drugs (PWID). We review the literature on the consequences of AUD on the effectiveness of HCV prevention and the cascade of care in PWID and provide recommendations for future research in the field of alcohol use and HCV.

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“…The alternative approach adopted by Lapointe-Shaw and others 2,5,6 uses HCV diagnosis as the anchor and identifies complications within a specified time window around this date. The question asked here is broader: what proportion of all HCV cases are diagnosed at a late stage?…”

Section: Two Different Approachesmentioning

confidence: 99%

“…Chirikov et al 6 Moorman et al 5 Lapointe-Shaw et al 2 0 0 9 1 9 9 2 1 9 9 3 1 9 9 4 1 9 9 5 1 9 9 6 1 9 9 7 1 9 9 8 1 9 9 9 2 0 0 0 2 0 1 3 2 0 1 4 2 0 1 5 2 0 0 1 2 0 0 2 2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7 2 0 1 0 2 0 1 1 2 0 1 2 2 0 0 8 2 0 0 9 1 9 9 2 1 9 9 3 1 9 9 4 1 9 9 5 1 9 9 6 1 9 9 7 1 9 9 8 1 9 9 9 2 0 0 0 2 0 1 3 (Table S1 contains more information on data source). DC, decompensated cirrhosis.…”

Section: Current Papermentioning

confidence: 99%

Reply to: “Pitfalls in measuring temporal trends for late diagnosis of viral hepatitis”

Wilton

Samji

et al. 2019

Journal of Hepatology

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Considerations for studying trends in late diagnosis of hepatitis C virus and its liver complications To the Editor: By the year 2030, the Global Health Sector Strategy on viral hepatitis aims to reduce mortality by 65% and new infections by 90%. Reaching these goals will require diagnosing 90% of people living with HCV and treating 80% of those diagnosed. However, since HCV infection remains asymptomatic until late stage complications manifest, diagnosis rates are concerningly low in many countries. Screening programs are intended to diagnose individuals in the asymptomatic phase and reduce late stage HCV diagnosis when decompensated cirrhosis (DC) or hepatocellular carcinoma (HCC) has already occurred. Monitoring trends in late diagnosis of HCV and its liver complications is an important indicator to evaluate the success of screening efforts and progress towards the strategy's goals.

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Contextual analysis of determinants of late Diagnosis of Hepatitis C Virus infection in medicare patients

Cited by 3 publications

References 0 publications

Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival

Late diagnosis of chronic liver disease in a community cohort (UK biobank): determinants and impact on subsequent survival

Alcohol Use Disorder and Hepatitis C Prevention and Care in People Who Inject Drugs: The State of Play

Reply to: “Pitfalls in measuring temporal trends for late diagnosis of viral hepatitis”

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