Independent Predictors of Mortality and Resource Utilization in Viral Hepatitis Related Hepatocellular Carcinoma

Golabi, Pegah; Jeffers, Thomas L.; Younoszai, Zahra; Otgonsuren, Munkhzul; Sayıner, Mehmet; Mishra, Alita; Venkatesan, Chapy; Younossi, Zobair M.

doi:10.5604/01.3001.0010.0290

Cited by 19 publications

(21 citation statements)

References 31 publications

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“…Indeed, our data showed that in 2005‐2016, compared to HCV‐negative HD recipients, HCV‐positive HD recipients had more of both outpatient and inpatient claims and longer inpatient hospitalization. In this context, the impact of HCV to resource utilization was previously reported and it is not dramatically different from that seen in the HD population. On the other hand, it is plausible that the chance of being identified as HCV positive may increase with receiving more episodes of care, which could also contribute to the reported differences in the resource utilization rates.…”

Section: Discussionmentioning

confidence: 63%

Prevalence, mortality and healthcare utilization among Medicare beneficiaries with Hepatitis C in Haemodialysis units

Deshpande

Stepanova

Golabi

et al. 2019

Journal of Viral Hepatitis

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Hepatitis C (HCV) is more common among patients with end-stage renal disease requiring haemodialysis compared to the general population. Thus, we aimed to assess trends in prevalence, health resource utilization and mortality among Medicare beneficiaries with HCV on haemodialysis. This is a retrospective study of outpatient and inpatient claims for Medicare beneficiaries receiving haemodialysis (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016).A total of 291 663 subjects on haemodialysis were included (67.3 ± 15.2 years, 55% male, 55% white, 49% age-based eligibility). The prevalence of HCV in subjects on haemodialysis was stable and was significantly higher (mean 4.2% in 2005-2016, P = 0.50 for the trend) than in subjects not on haemodialysis (<1%). In multivariate analysis, liver cirrhosis (odds ratio = 3.4 (95% CI = 3.3-3.6)) was an independent predictor of 1-year mortality among haemodialysis patients. Mean total inpatient payments in dialysis patients with HCV remained stable during 2005 ($73 803) through 2016 ($72 133) (trend P = 0.54) while mean total outpatient payment decreased from 2005 ($53 497) to 2016 ($35 439; trend P = 0.0013). In multivariate analysis, after adjustment for age, gender, race and location, both HCV and cirrhosis remained significant contributors to greater spending [HCV: inpatient

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Section: Discussionmentioning

confidence: 63%

Prevalence, mortality and healthcare utilization among Medicare beneficiaries with Hepatitis C in Haemodialysis units

Deshpande

Stepanova

Golabi

et al. 2019

Journal of Viral Hepatitis

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“…In fact, nonalcoholic steatohepatitis (NASH) as an indication for LT has risen substantially so that it is currently the second most common indication for LT in the US, [ 5 , 6 ] synchronously with a steady increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) and its complications in the US. [ 1 – 4 ] This trend is also affected by a simultaneous decrease in the number of patients with HCV requiring LT because of highly effective and safe antiviral treatments for HCV infection, [ 7 – 9 ] while no similarly effective treatment option exists for NAFLD. In fact, it is predicted that the combination of these 2 factors could push NASH or the progressive form of NAFLD, to become the most common indication for LT in the near future.…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation (LT) for Cryptogenic Cirrhosis (CC) and Nonalcoholic Steatohepatitis (NASH) Cirrhosis

et al. 2018

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“…CHB can cause cirrhosis, hepatocellular carcinoma, liver failure, and death. CHB is also associated with extra‐hepatic manifestations, decreased quality of life, and increased economic burden . As such, the 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030…”

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confidence: 99%

Prevalence of Undetectable Vaccine‐Induced Immunity Against Hepatitis B Virus in US Adults at High Risk for Infection

Yeo

Chang

et al. 2019

Hepatology

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In 2015, the Centers for Disease Control and Prevention reported a substantial increase in the number of acute hepatitis B virus (HBV) infections in the United States. Although national guidelines recommend vaccination of adults at high risk for HBV infection, the prevalence of undetectable immunity (i.e., susceptibility) in this population remains unknown. In this study, we analyzed a nationally representative sample using the National Health and Nutrition Examination Survey to evaluate the prevalence, trend, and predictors of undetectable vaccine‐induced antibodies against HBV surface antigen (<10 mIU/mL) among high‐risk adults from 2003‐2014. Among adults at high risk for HBV infection, the prevalence of undetectable immunity decreased from 83.2% in 2003‐2004 (95% confidence interval [CI]: 81.3‐85.0) to 69.4% (about 64 million) in 2013‐2014 (95% CI: 66.0‐72.6). The prevalence decreased significantly in individuals with multiple sex partners or sexually transmitted disease and in pregnant women. However, there were no significant changes in men who have sex with men (MSMs), intravenous drug users (IDUs), hepatitis C virus (HCV)‐infected and patients with diabetes, and those with elevated aspartate aminotransferase/alanine aminotransferase (AST/ALT). Mexican Americans had the highest prevalence of undetectable immunity (77.6%, 95% CI: 72.6‐81.9), followed by non‐Hispanic whites (70.1%, 95% CI: 66.9‐73.1). Older age, lower socioeconomic status, and having at least 1 high‐risk factor were associated with a higher risk of undetectable immunity, whereas an increased risk among the foreign‐born disappeared after multivariable adjustment. Conclusion: Approximately 64 million high‐risk adults in the United States remain susceptible to HBV infection, especially MSMs, IDUs, diabetics, HCV patients, and populations with elevated AST/ALT. To eliminate HBV, efforts should be made to increase screening and vaccination in high‐risk adults.

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Independent Predictors of Mortality and Resource Utilization in Viral Hepatitis Related Hepatocellular Carcinoma

Abstract: The rate of viral hepatitis-related HCC is increasing. Mortality and resource utilization related to HBV and HCV-related HCC is substantial.

Cited by 19 publications

References 31 publications

Prevalence, mortality and healthcare utilization among Medicare beneficiaries with Hepatitis C in Haemodialysis units

Prevalence, mortality and healthcare utilization among Medicare beneficiaries with Hepatitis C in Haemodialysis units

Liver Transplantation (LT) for Cryptogenic Cirrhosis (CC) and Nonalcoholic Steatohepatitis (NASH) Cirrhosis

Prevalence of Undetectable Vaccine‐Induced Immunity Against Hepatitis B Virus in US Adults at High Risk for Infection

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