Estimating the impact of hepatitis C virus therapy on future liver-related morbidity, mortality and costs related to chronic hepatitis C

Buti, María; Miguel, Ramón San; Brosa, Max; Cabasés, Juan M.; Medina, Montserrat; Casado, Miguel; Fosbrook, Leslie; Esteban, Rafael

doi:10.1016/j.jhep.2004.12.031

Cited by 101 publications

(75 citation statements)

References 37 publications

(43 reference statements)

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“…SVR has been linked with constant improvement of quality of life, 111,112 histological improvement, 48,113 decreased risk of development of liver cancer, 114,115 and reduced liver-related mortality. 116,117 Data about persistent detection of HCV RNA in liver samples or PBMCs are conflicting, but the majority of data indicate that patients with SVR also clear HCV RNA from liver. 48,118 Articles on "occult" HCV infection that report very high rates of detectability of HCV RNA in patients with cryptogenic liver disease or former hepatitis C were published by yet only five groups.…”

Section: Discussionmentioning

confidence: 99%

Occult hepatitis C: How convincing are the current data? #

Welker

Zeuzem

2009

Hepatology

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Section: Discussionmentioning

confidence: 99%

Occult hepatitis C: How convincing are the current data? #

Welker

Zeuzem

2009

Hepatology

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“…Several studies using different methodologies, all conducted in developed countries, have consistently forecasted an increase in morbidity, mortality and economic burden based on currently existing infections, even in those countries where a decrease in incidence was observed (22)(23)(24)(25)(26). Costeffectiveness ratios calculated in several studies have been shown to be comparable to other well-accepted medical interventions (27)(28)(29). However, in order to take the most adequate decision at the national level, one should be aware that disease costs, drug costs or the annual discount rate may differ for each country, not to mention the different health reimbursement systems, the different population's age, gender and ethnicity balances or quality-of-life baselines.…”

Section: The Economics Of Hepatitis Cmentioning

confidence: 93%

The global burden of hepatitis C

Lavanchy

2009

Liver International

1,223

904

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Hepatitis C is of concern both to industrialized and developing countries. Preliminary unpublished estimates of the global burden of disease (GBD) attributable to HCV-related chronic liver disease seem to be substantial. Therefore, the reduction of global mortality and morbidity related to chronic hepatitis C should be a concern to public health authorities, and primary, secondary and tertiary prevention activities should be implemented and monitored in each country, with precise targets set to be reached. In order to decide on national health policies, there is a need to estimate the burden of disease, globally, regionally and nationally. To evaluate the GBD, three components have to be assessed: 1) The global, regional and national burden of morbidity and mortality associated with HCV infection, based on prevalence, incidence, transmission and economics; 2) The natural history of HCV infection, including 'healthy individuals'; and 3) The areas for which more research is needed. A working group was created to assist the World Health organization (WHO) in estimating the GBD associated with HCV infection.

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“…An accelerated course of disease was indeed highlighted by a recent follow-up analysis in a unique cohort of Irish women who were diagnosed with chronic HCV genotype 1b infection following a single-source outbreak of HCV (due administration of contaminated anti-D immunoglobulin) from 1977 to 1979 [34]. Either way, it is expected that the number of patients with HCV-induced cirrhosis, and consequently the number with cirrhosis-related complications, will rise during the upcoming years [35,36].…”

Section: Hepatic Manifestations Of Chronic Hcv Infectionmentioning

confidence: 99%

Reversion of disease manifestations after HCV eradication

Meer

Berenguer

2016

Journal of Hepatology

161

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Chronic infection with the hepatitis C virus (HCV) may lead to hepatic fibrosis and eventually cirrhosis, at which stage, patients have a substantial risk of liver failure, hepatocellular carcinoma (HCC) and liver-related death. Moreover, HCV infection is associated with several extrahepatic manifestations which impact the quality of life and increase the non-liver-related mortality rate. For patients with compensated liver disease, interferon (IFN)-based antiviral therapy has been a treatment option for over two decades. Long-term follow-up studies indicated that among those with sustained virological response (SVR) the extend of hepatic fibrosis can regress and that their risk of cirrhosis-related complications (including HCC) is reduced, also in case of cirrhosis. Recent population-based studies extended these observations for solid extrahepatic outcomes, such as end-stage renal failure and cardiovascular events. Most importantly, SVR has been associated with prolonged overall survival. These results highlight the importance of the development of new direct-acting antivirals (DAAs), by which almost all patients are able to eradicate HCV in a comfortable manner. Based on the excellent first experiences with the DAAs, physicians gained confidence to use these drugs among patients with decompensated cirrhosis on a more regular basis as well. This was not possible with interferon therapy. Also in this high risk population the DAAs show high SVR rates with improvements in biochemical parameters of liver function shortly after therapy, especially in case of SVR. In fact, some patients could actually be removed from the liver transplantation waiting list due to clinical improvement following DAA therapy. How these short-term results translate into a prolonged (long-term) survival has yet to be determined, as well as which patients with decompensated liver disease are likely or not to benefit from viral eradication. Here we review the current data regarding the beneficial clinical outcome with antiviral therapy as well the remaining uncertainties in this field, both for patients with compensated liver disease and patients with decompensated liver disease.

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Estimating the impact of hepatitis C virus therapy on future liver-related morbidity, mortality and costs related to chronic hepatitis C

Cited by 101 publications

References 37 publications

Occult hepatitis C: How convincing are the current data? #

Occult hepatitis C: How convincing are the current data? #

The global burden of hepatitis C

Reversion of disease manifestations after HCV eradication

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