Epidemiology and Clinical Characteristics of Individuals with Hepatitis C Virus Infection in the United States, 2017–2019

Reau, Nancy; Sulkowski, Mark S.; Thomas, Emmanuel; Sundaram, Vinay; Xu, Qingqing; Cheng, William C.; Marx, Steven E.; Hayes, Oscar; Manthena, Shivaji; Chirikov, Viktor; Dylla, Douglas E.; Brooks, Hannah; Carabino, Jana; Saab, Sammy

doi:10.1007/s12325-021-01928-y

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…Likewise, rises in HCV infections have been linked to the opioid epidemic, and it is possible that treating addiction is prioritized over treating concurrent HCV [ 7 ]. Treatment estimates in Florida are in line with recently published national estimates [ 24 ], despite data from the current study showing that the number of HCV Ab screenings per 100,000 persons in Florida is nearly double that of national rates (4809 vs. 2417) and that the number of HCV RNA-positive individuals per 100,000 persons in Florida is also higher (149 vs. 110) [ 24 ], thus suggesting that improvements in linkage to care and treatment are needed.…”

Section: Discussionsupporting

confidence: 87%

“…As of 2020, most of these states had no restrictions on fibrosis staging (except TX) in order to receive treatment, but 7 had sobriety requirements (no restrictions in CA or OH). Rates of treatment in these states is in line with national estimates [ 24 ], except in Ohio (10%) and Michigan (15%) [ 29 ]. In Ohio, Medicaid did not cover treatment for patients with low fibrosis scores (< F2), and only approved treatment once disease progressed.…”

Section: Discussionsupporting

confidence: 77%

“…The current study demonstrated a bimodal age distribution of HCV RNA-positive persons, suggesting that screening efforts cannot simply target one population, further bolstering the need for universal screening. In 2019, less than one-third of HCV RNA-positive patients received treatment, similar to the 26.8% of HCV RNA-positive patients nationally that received treatment in 2019 [ 24 ]. The decline in treatment rates may be partly due to the fact that fewer patients are treated year after year.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment initiation was assumed if an individual showed a decline in HCV RNA levels based on a viral load decline of at least 1.2 × log 10 units from the time of their first positive HCV RNA test. Machine-learning algorithms were developed to identify patients who were cured and had been previously described [ 23 , 24 ]. Briefly, machine-learning algorithms were validated using a separate set of data from 92,099 treated HCV individuals with medical and pharmacy claims available in the Symphony Health Solutions claims database from 2015 to 2019.…”

Section: Methodsmentioning

confidence: 99%

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Awareness and Epidemiology of Chronic Hepatitis C Virus Infections in Florida

et al. 2021

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Introduction: Progress towards achieving hepatitis C virus (HCV) elimination in Florida has been hampered by barriers to screening, linkage to care, and treatment. This study aims to describe the HCV care cascade and patient characteristics in Florida. Methods: This analysis combined HCV-related laboratory data and patient characteristics from two, large US laboratory datasets that included individuals tested for HCV antibody (Ab) and HCV ribonucleic acid (RNA) viral load between January 2015 and December 2019. A decline in sequential HCV RNA viral loads was used to impute HCV treatment. Machine-learning algorithms were used to identify cured patients. The actual number of individuals with HCV Ab screening, and the number and percentage of persons who were HCV RNA-positive and treated, were calculated. Results: The number of persons in Florida diagnosed as HCV RNA-positive was 31,659 in 2019. The number of individuals HCV Ab screened in 2019 was 1,024,379, an increase of 82.5% from 2015. The percentage of HCV Abpositive individuals was 4.1%, demonstrating a 16.2% decrease from 2015. The percentage of HCV RNA-positive patients who were treated was 27.0%, a 10.5% decrease from 2015 to 2019. Conclusion: An Ab positivity rate[4-times higher than national estimates with increased screening among baby boomers, but decreased screening among younger individuals, suggests risk-based screening is still common practice in Florida, despite universal screening recommendations. Public health efforts to decrease barriers to screening, linkage to care, and treatment are needed to reduce the burden of HCV in Florida and to ensure progress toward virus elimination.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Awareness and Epidemiology of Chronic Hepatitis C Virus Infections in Florida

et al. 2021

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“…7 To reduce this burden, we need to diagnose chronic liver diseases at an early stage, well before the development of decompensated cirrhosis or hepatocellular carcinoma. Currently, patients with chronic viral hepatitis often have advanced liver disease at the time of diagnosis; in the USA, 13•1% (47 466/363 532) of individuals screened for HCV antibodies, HCV RNA, or both in 2019 by two large laboratory companies had stage 4 liver fibrosis (ie, liver cirrhosis) 8 and, in Thailand, a country where HBV is endemic, patient awareness of their risk for developing hepatocellular carcinoma and adherence to regular surveillance for it are low.…”

mentioning

confidence: 99%

Chronic liver diseases must be reduced worldwide: it is time to act

Vento

Cainelli

2022

The Lancet Global Health

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Real-World Effectiveness of 8-Week Glecaprevir/Pibrentasvir in Treatment-Naïve, Compensated Cirrhotic HCV Patients

et al. 2023

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Introduction The EXPEDITION-8 clinical trial has demonstrated that treatment-naïve patients with compensated cirrhosis (TN/CC) of HCV genotypes 1–6 can achieve a 98% intent-to-treat sustained virologic response rate 12 weeks post-treatment with an 8-week glecaprevir/pibrentasvir (G/P) regimen. Further real-world evidence is needed to support the effectiveness of 8-week G/P in a clinical practice setting and to consolidate these treatment recommendations. The aim of this study is to contribute real-world evidence for the effectiveness of an 8-week G/P treatment in TN/CC patients with HCV genotypes 1–6. Methods Retrospective real-world data from 494 TN/CC patients with HCV genotypes 1–6 were collected between August 2017 to December 2020 from the Symphony Health Solutions administrative claims database. Demographic and clinical characteristics were collected at baseline. Patients were required to have a follow-up HCV ribonucleic acid level at least 8 weeks or more after the end of treatment. The percentage of patients achieving a sustained virologic response (SVR) is reported. Results The majority of patients were male (58%) and Caucasian (40%), with a mean age of 58 years; 74%, 12%, 12%, and 1% of patients were HCV genotype 1, 2, 3, and 4–6 infected, respectively. SVR was achieved in 95.5% of all patients. Across patient subgroups, SVR was achieved in 95.6% of patients with HCV genotype 3 and in 93% of HCV patients with a recent diagnosis of illicit drug use or abuse (within 6 months prior to G/P initiation). Conclusion Early real-world evidence indicates high effectiveness of the 8-week G/P regimen in TN/CC patients of HCV genotypes 1–6 from a large US claims database. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00823-z.

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Epidemiology and Clinical Characteristics of Individuals with Hepatitis C Virus Infection in the United States, 2017–2019

Cited by 9 publications

References 18 publications

Awareness and Epidemiology of Chronic Hepatitis C Virus Infections in Florida

Awareness and Epidemiology of Chronic Hepatitis C Virus Infections in Florida

Chronic liver diseases must be reduced worldwide: it is time to act

Real-World Effectiveness of 8-Week Glecaprevir/Pibrentasvir in Treatment-Naïve, Compensated Cirrhotic HCV Patients

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