Reduced healthcare utilization following successful hepatitis C virus treatment in HIV-co-infected patients with mild liver disease

Padam, P., Clark, S., Irving, W., Gellissen, R., Thomson, E. , Main, J. and Cooke, G.S. (2016) Reduced healthcare utilization following successful hepatitis C virus treatment in HIV-co-infected patients with mild liver disease. Journal of Viral Hepatitis, 23(2), pp. 123-129. (doi: 10.1111/jvh.12484) (PMID:26511293) (PMCID:PMC4924594)

[img]
Preview
Text
116675.pdf - Published Version
Available under License Creative Commons Attribution.

421kB

Abstract

New direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection have achieved high cure rates in many patient groups previously considered difficult-to-treat, including those HIV/HCV co-infected. The high price of these medications is likely to limit access to treatment, at least in the short term. Early treatment priority is likely to be given to those with advanced disease, but a more detailed understanding of the potential benefits in treating those with mild disease is needed. We hypothesized that successful HCV treatment within a co-infected population with mild liver disease would lead to a reduction in the use and costs of healthcare services in the 5 years following treatment completion. We performed a retrospective cohort study of HIV/HCV-co-infected patients without evidence of fibrosis/cirrhosis who received a course of HCV therapy between 2004 and 2013. Detailed analysis of healthcare utilization up to 5 years following treatment for each patient using clinical and electronic records was used to estimate healthcare costs. Sixty-three patients were investigated, of whom 48 of 63 (76.2%) achieved sustained virological response 12 weeks following completion of therapy (SVR12). Individuals achieving SVR12 incurred lower health utilization costs (£5000 per-patient) compared to (£10 775 per-patient) non-SVR patients in the 5 years after treatment. Healthcare utilization rates and costs in the immediate 5 years following treatment were significantly higher in co-infected patients with mild disease that failed to achieve SVR12. These data suggest additional value to achieving cure beyond the prevention of complications of disease.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Thomson, Professor Emma
Authors: Padam, P., Clark, S., Irving, W., Gellissen, R., Thomson, E., Main, J., and Cooke, G.S.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
Journal Name:Journal of Viral Hepatitis
Publisher:Wiley-Blackwell Publishing Ltd.
ISSN:1352-0504
ISSN (Online):1365-2893
Published Online:29 October 2015
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Journal of Viral Hepatitis 23(2): 123-129
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record