Clinical and epidemiological features of hepatitis C virus infection in South Korea: A prospective, multicenter cohort study

Seong, Mun Hyuk; Kil, Ho; Kim, Young Seok; Bae, Si Hyun; Lee, Youn Jae; Lee, Han Chu; Kang, Byung Hak; Jeong, Sook Hyang

doi:10.1002/jmv.23661

Cited by 64 publications

(77 citation statements)

References 32 publications

(37 reference statements)

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“…These higher SVR rates in Korean patients seem to be partly explained by a higher proportion of favorable IL-28B polymorphisms [17]. Also, the demographic patterns, including risk factors and genotype distribution, of the Korean HCV patients were different from those of other countries [18]. The natural history and risk factors for disease progression of chronic HCV infection have primarily been studied in Western countries or Japan, and there is little information on Korean patients [5,19,20].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Chronic Hepatitis C Patients Treated with Interferon-Alpha: Risk of Cirrhosis and Hepatocellular Carcinoma in a Single Center over 10 Years

Lee

Yeon²,

Yoon³

et al. 2015

Intervirology

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Objectives: Interferon (IFN)-based therapy for chronic hepatitis C (CHC) is cost-effective and is associated with reduced risk of disease progression. We aimed to assess the incidence of cirrhosis and hepatocellular carcinoma (HCC) and to identify risk factors associated with disease progression. Methods: We retrospectively reviewed 280 CHC patients who were registered at our hospital between 2001 and 2010. Results: About 80% of patients received antiviral treatment. The 10-year cumulative incidence of cirrhosis was significantly lower among patients who received antiviral therapy than among those who did not (8.3 vs. 44.0%; p = 0.001). Among them, patients with sustained virological response (SVR) had a significantly lower incidence of cirrhosis than those without SVR (0.6 vs. 33.9%; p < 0.001). Cox proportional hazards regression showed that SVR was the significant independent factor for reducing the risk of cirrhosis (hazard ratio, HR = 0.03; p = 0.034). The 10-year cumulative incidence of HCC was higher among patients who did not receive antiviral therapy than among those who did (43.9 vs. 6.1%; p < 0.001). Multivariate analysis showed that underlying cirrhosis was the only independent risk factor associated with HCC development (HR = 7.70; p = 0.010). Conclusions: SVR secondary to IFN-based therapy could reduce cirrhosis development in CHC patients. Underlying cirrhosis was the strongest predictor of HCC development.

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Chronic Hepatitis C Patients Treated with Interferon-Alpha: Risk of Cirrhosis and Hepatocellular Carcinoma in a Single Center over 10 Years

Lee

Yeon²,

Yoon³

et al. 2015

Intervirology

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“…From a public health perspective, efforts are currently focused toward the implementation of treatment strategies that may decrease rates of onward transmission [5]. Globally, there has been considerable interest in assessing the cost-effectiveness of screening programs for HCV; analyses have been performed in several countries with a high prevalence of HCV including the US, Japan and Egypt [6–12].…”

Section: Introductionmentioning

confidence: 99%

Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

et al. 2017

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Background and AimsThis study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40–70, compared to current practice (no screening).MethodsA published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40–49, 50–59 and 60–69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised.ResultsScreening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD.ConclusionsOne-time HCV screening and treatment in South Korean people aged 40–70 is likely to be highly cost-effective compared to the current practice of no screening.

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“…[19] Using those cohort data, this study aimed to elucidate the incidence of liver cirrhosis, HCC, and all-cause mortality in chronic hepatitis C patients, and to identify the risk factors related to those clinical outcomes. To the best of our knowledge, this is the first prospective cohort study in a real-world clinical practice that observed the major outcomes of chronic hepatitis C patients in an HBV-prevalent Asian region.…”

Section: Introductionmentioning

confidence: 99%

The clinical outcomes of chronic hepatitis C in South Korea

Jeong²,

Jang³

et al. 2016

Medicine

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This prospective cohort study aimed to elucidate the clinical outcome and its related factors of chronic hepatitis C in a hepatitis B-dominant Asian region.From January 2007 to October 2012, 382 patients with chronic hepatitis C without liver cirrhosis were prospectively enrolled at 6 university hospitals, and regularly followed until Apr 2014 to identify the development of liver cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), and overall survival.During the median follow-up of 39.0 months (range 18.0–81.0 months), liver cirrhosis, hepatic decompensation, and HCC developed in 42 patients (11.0%), 4 patients (1.0%), and 12 patients (3.1%), respectively. The cumulative probability of development of cirrhosis at 3 years and at 5 years was 9.6% and 16.7%, respectively. That of HCC at 3 and 5 years was 1.6% and 4.5%, respectively. The 3-year and 5-year overall survival rate was 99.7% and 96.0%, respectively. Pegylated interferon-based antiviral therapy was undertaken in 237 patients (62.0%) with a sustained virologic response (SVR) rate of 74.3%. The factors related to the overall clinical outcomes were age ≥55 years (HR 2.924, P = 0.016), platelet counts <150 × 109/L (HR 3.195, P = 0.007), and the achievement of SVR (HR 0.254, P = 0.002).The clinical outcomes of this Korean chronic hepatitis C cohort were modest with minimal mortality, but significant disease progression occurred in the patients with old age, low platelet, and non-SVR after interferon-based antiviral treatment or no treatment, suggesting priority for direct acting antiviral therapy.

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Clinical and epidemiological features of hepatitis C virus infection in South Korea: A prospective, multicenter cohort study

Cited by 64 publications

References 32 publications

Long-Term Follow-Up of Chronic Hepatitis C Patients Treated with Interferon-Alpha: Risk of Cirrhosis and Hepatocellular Carcinoma in a Single Center over 10 Years

Long-Term Follow-Up of Chronic Hepatitis C Patients Treated with Interferon-Alpha: Risk of Cirrhosis and Hepatocellular Carcinoma in a Single Center over 10 Years

Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

The clinical outcomes of chronic hepatitis C in South Korea

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