Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany?

Journal of Clinical Gastroenterology
Jenny BischoffGECCO study group

Abstract

International guidelines recommend prioritized treatment initiation in hepatitis C virus (HCV)-infected patients with advanced liver disease. We aimed to evaluate whether the widespread usage of direct acting antivirals (DAAs) has led to a decrease in late presentation for care. Data derived from the multicenter German Hepatitis C Cohort (GECCO) was analyzed. Treatment naive HCV-infected patients initiating DAA-based treatment between January 2014 and September 2017 were included. Advanced liver disease was defined by aspartate aminotransferase to platelet ratio index score ≥1.5, METAVIR≥F3, or FibroScan ≥9.5 kPa. Period prevalence and risk factors for late presentation were evaluated. Six hundred fifty-three HCV-monoinfected and 210 HIV/HCV-coinfected patients (mean age, 48.6±12.7 y; 65.5% male) were included. Overall 32.5% of patients had advanced liver disease. In 2014 39.4% of patients presented with advanced liver disease, decreasing to 30.1%, 34.4%, and 26.4% in the years 2015, 2016, and 2017 (P=0.057), respectively. Patients with and without advanced liver disease differed in age (P<0.0001), CD4 ≤350/µL (P=0.027), genotype (P=0.005), transmission route (P=0.047), body mass index (P<0.001), and time since diagnosis (P=0.0...Continue Reading

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Citations

Jul 20, 2019·Nature Reviews. Gastroenterology & Hepatology·Jeffrey V LazarusMaria Buti
Jul 30, 2020·Seminars in Liver Disease·Jean-Michel PawlotskyJeffrey V Lazarus
Jul 22, 2021·Journal of Viral Hepatitis·Jenny BischoffUNKNOWN German Hepatitis C-Registry
Sep 15, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Melina SantosUNKNOWN ANRS CO22 HEPATHER study group

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Methods Mentioned

BETA
biopsy

Software Mentioned

IVDA
SPSS

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