Socioeconomic status in HCV infected patients &amp;ndash; risk and prognosis

Omland, Lars Haukali; Osler, Merete; Jepsen, Peter; Krarup, Henrik; Weis, Nina; Christensen, Peer Brehm; Roed, Casper; Sørensen, Henrik Toft; Obel, Niels

doi:10.2147/clep.s43926

Cited by 66 publications

(54 citation statements)

References 44 publications

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“…The employment rates used in our model were sourced from a real‐world analysis of HCV patients; few other real‐world studies have examined labour force participation among European HCV patients, but those who do report employment rates (30% to 60%) that are in line to what was sourced for the present analysis. Nonetheless, these studies and the real‐world analyses used to feed our own model inputs estimate a lower participation than have been reported in clinical trials .…”

Section: Discussionmentioning

confidence: 99%

Impact of eradicating hepatitis C virus on the work productivity of chronic hepatitis C (CH‐C) patients: an economic model from five European countries

Younossi

Brown

Buti

et al. 2015

Journal of Viral Hepatitis

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CH-C negatively affects work productivity (WP), creating a large economic burden. The aim of this study was to model the impact of sustained virologic response (SVR) on WP in CHC genotype 1 (GT1) patients in five European countries (EU5). Work Productivity and Activity Index-Specific Health Problem questionnaire was administered to patients across the ION clinical trials (n = 629 European patients). The analysis modelled a population of GT1 CHC patients over one year, who had been either not treated or treated with LDV/SOF. Sensitivity analyses assessed the possibility that CHC patients' labour costs were lower than the general population's and presented results by fibrosis stage. Before initiation of treatment, EU patients with CHC GT1 exhibited absenteeism and presenteeism impairments of 3.54% and 9.12%, respectively. About 91.8% of EU patients in the ION trials achieved SVR and improved absenteeism and presenteeism impairments by 16.3% and 19.5%, respectively. Monetizing these data, treatment with LDV/SOF resulted in an annual productivity gain of €435 million and a weighted average per-employed patient (PEP) gain of €900 in the EU5. PEP gains from treatment are projected to be higher in cirrhotic than in noncirrhotic patients. If CHC patients are assumed to earn 20% less than the general population, gains of €348 million (€720 PEP) annually are projected. CHC results in a significant economic burden to European society. Due to improvements in WP, SVR with treatment could provide substantial economic gains, partly offsetting the direct costs related to its widespread use.

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Section: Discussionmentioning

confidence: 99%

Impact of eradicating hepatitis C virus on the work productivity of chronic hepatitis C (CH‐C) patients: an economic model from five European countries

Younossi

Brown

Buti

et al. 2015

Journal of Viral Hepatitis

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“…Lower educational level, which may be considered an indirect indicator of low socioeconomic status, has been found to be associated with high prevalence of HCV infection in previous cross‐sectional studies in the United States [Alter et al, ; Armstrong et al, ; Denniston et al, ], Norway [Dalgard et al, ], Denmark [Omland et al, ], France [Meffre et al, ], Spain [García Comas et al, ], Germany [Niederau et al, ], Puerto Rico [Pérez et al, ], and Pakistan [Maan et al, ]. Moreover, a recent US‐based study has shown that an educational level of starting college or higher is protective of death for HCV infection as compared to an educational level of less than high school [Ly et al, ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of HCV infection in a metropolitan area in southern Italy: Tail of a cohort infected in past decades

Morisco

Loperto

Stroffolini³

et al. 2016

Journal of Medical Virology

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Data on the prevalence of HCV infection in Italy are often outdated and from non-urban populations. This study assessed the prevalence and risk factors for HCV infection in a large metropolitan area in southern Italy. A random 1:3 systematic sample of the adult general population of Naples was selected from three general practitioner patient registers in three different city districts. Socioeconomic indicators and risk factors for HCV infection were collected. Anti-HCV and HCV-RNA assays were performed. Logistic regression analysis was used to identify independent predictors of HCV infection. Of 1,500 randomly selected subjects, 1,315 (87.7%) participated in the study. Forty subjects (3.0%; 95%CI: 2.1-4.0) were anti-HCV-positive, with HCV-RNA detected by PCR in 31 (77.5%) of these. Anti-HCV prevalence increased with age, peaking (8.2%) in people born during the years 1945-1955. It was 1.7% in people residing in the better socioeconomic districts; but 5.7% in those residing in the district with lower socioeconomic status (P < 0.01). In multivariate analysis, age ≥60 years (OR 2.8, 95%CI: 1.3-6.1) and lower educational level (OR 3.6; 95%CI: 1.4-9.3), which is a proxy of low socioeconomic status, were the only independent predictors of the likelihood of anti-HCV positivity. Overall, 22.5% of anti-HCV positive subjects were previously unaware of their status. In the large city of Naples, infection with HCV is most common in people aged older than 60 years. Differences in socioeconomic conditions have played an important role in the spread of this infection. HCV positive subjects born during the years 1945-1955 are those who may benefit, to a greater extent, to be identified in order to receive the new effective therapy. J. Med. Virol. 89:291-297, 2017. © 2016 Wiley Periodicals, Inc.

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“…Variables based on a priori hypotheses 17,31,32 and those significant at 0.10 in the univariate analysis were included in the multivariable models, and adjusted odds ratios (aOR) are reported with 95% CI. To avoid nonidentification problem, we did not include age, birth cohort and HCV diagnosis year in the same adjusted model.…”

Section: Discussionmentioning

confidence: 99%

Role of primary T‐cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort

Islam

Krajden

Gilbert

et al. 2016

Journal of Viral Hepatitis

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T-cell host immune response against hepatitis C virus (HCV) has been suggested to play an important role in determining HCV infection outcome. However, data from human studies are not available. This study examined the effect of primary T-cell deficiency along with other factors on the spontaneous clearance of HCV in a large population-based cohort in British Columbia, Canada. The BC Hepatitis Testers Cohort includes all individuals tested for HCV in BC in 1990-2013 linked with data on their medical visits, hospitalizations and prescription drugs. HCV-positive individuals with at least one valid HCV PCR test on/after HCV diagnosis (n=46 783) were included in this study. To examine factors associated with the spontaneous clearance of HCV, multivariable logistic regression was fitted on the full sample, and Cox proportional hazards model on the HCV seroconverters. Spontaneous clearance was observed in 25.1% (n=11 737) of those tested for HCV. After adjusting for potential confounders, the odds of spontaneous clearance of HCV was lower in people with primary T-cell immunodeficiency (adjusted odds ratio [aOR]: 0.55, 95% CI: 0.32-0.94), and higher in females (aOR: 1.61, 95% CI: 1.54-1.68) and in those coinfected with HBV (aOR: 2.31, 95% CI: 1.93-2.77). Similar results were observed in HCV seroconverters except HBV coinfection was not significant. In conclusion, primary T-cell immunodeficiency is associated with a lower spontaneous clearance of HCV while female sex and coinfection with HBV are associated with a higher spontaneous clearance.

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Socioeconomic status in HCV infected patients – risk and prognosis

Cited by 66 publications

References 44 publications

Impact of eradicating hepatitis C virus on the work productivity of chronic hepatitis C (CH‐C) patients: an economic model from five European countries

Impact of eradicating hepatitis C virus on the work productivity of chronic hepatitis C (CH‐C) patients: an economic model from five European countries

Prevalence and risk factors of HCV infection in a metropolitan area in southern Italy: Tail of a cohort infected in past decades

Role of primary T‐cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort

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