Cohort Profile: The Hepatitis C Virus (HCV) Research UK Clinical Database and Biobank

McLauchlan, John; Innes, Hamish; Dillon, John; Foster, Graham R.; Holtham, Elizabeth; McDonald, Sarah E.; Wilkes, B.; Hutchinson, Sharon J.; Irving, William L.

doi:10.1093/ije/dyw362

Cited by 27 publications

(36 citation statements)

References 14 publications

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“…The relative distribution of persons across liver fibrosis states metavir F0‐F3 was consistent with similar models and based on an HCV cohort entering an HCV treatment trial (Table A) . However, the proportion with compensated cirrhosis at time 0 was based on the HCV‐UK cohort, which we felt was more representative of the background population disease distribution …”

Section: Methodssupporting

confidence: 72%

“…28 However, the proportion with compensated cirrhosis at time 0 was based on the HCV-UK cohort, which we felt was more representative of the background population disease distribution. 29 Transition probabilities between disease stages and the health utility associated with each stage were based on published literature and were assumed to be the same for people who inject drugs (PWID) and non-PWID (Table 1B, (Table 1B). 4,5,35…”

Section: Parameters Used In the Modelmentioning

confidence: 99%

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The testing of people with any risk factor for hepatitis C in community pharmacies is cost‐effective

Buchanan

Cooper

Grellier

et al. 2019

Journal of Viral Hepatitis

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New antiviral drugs with high efficacy mean the hepatitis C virus (HCV) can now be eliminated. To achieve this, it is necessary to identify undiagnosed cases of HCV. However, the costs of testing should be considered when judging the overall cost‐effectiveness of treatment. This study describes the cost‐effectiveness of a community pharmacy testing service in a population of people at risk of HCV living on the Isle of Wight (United Kingdom). Dry blood spot testing was conducted in anyone with a known risk factor for HCV in 20 community pharmacies. The outcomes and costs were entered into a Markov model. Cost and health utilities from the model were used to calculate an incremental cost‐effectiveness ratio (ICER). In 24 months, 186 tests were conducted, 13 were positive for HCV RNA and six of these (46%) received treatment during the follow‐up period. All achieved a sustained virological response at 3 months. The overall cost of the testing and treatment intervention was £242 183, and the ICER for the service was £3689 per quality‐adjusted life year (QALY) gained. If screening had been restricted to just people with a history of injecting drug use (PWID) the ICER would have been £4865 per QALY gained. The service was effective at identifying people with HCV infection, and despite the additional cost of targeted testing, its cost‐effectiveness was below the commonly accepted thresholds. In this setting, restricting targeted testing to PWID would not improve the cost‐effectiveness.

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Section: Methodssupporting

confidence: 72%

Section: Parameters Used In the Modelmentioning

confidence: 99%

The testing of people with any risk factor for hepatitis C in community pharmacies is cost‐effective

Buchanan

Cooper

Grellier

et al. 2019

Journal of Viral Hepatitis

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“…Thus, all were younger than the Korean HCV cohort on average. [14][15][16] This difference may be related to the different risk factors of HCV infection, in this case the high prevalence of IVDU in the Western cohorts (>30%), in contrast to the Korean cohort (5.6%), as IVDU is more common in young males than in older or female populations. 17 Our results also showed that the risk factor profiles for HCV infection were significantly different between male and female patients.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and Clinical Characteristics of Hepatitis C Virus Infection in South Korea from 2007 to 2017: A Prospective Multicenter Cohort Study

et al. 2020

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Background/Aims: This study aimed to elucidate the epidemiological and clinical characteristics of chronic hepatitis C (CHC) patients in South Korea from 2007 to 2017 and to compare the treatment patterns between two periods before and after the first approval of direct-acting antivirals (DAA) in South Korea in 2015. Methods: This prospective, multicenter cohort enrolled 2,758 patients with hepatitis C virus (HCV) viremia at seven tertiary centers, and clinical data were prospectively collected with questionnaire surveys focused on lifetime risk factors related to HCV infection. Results: The HCV patients had a mean age of 57.3 years (50.8% male). Among them, 14.3% showed a positive history of transfusion before HCV screening and 5.6% reported intravenous drug use (IVDU), with significant differences in these risk factors between men and women. The proportions of patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC) were 69.5%, 18.9%, and 11.5%, respectively. The mean alanine aminotransaminase level was within the upper normal limit at 49.9%, and the major genotypes were 1b (48.2%) and 2 (46.4%). The overall treatment rate was 53.8%, showing a rapid transition from interferon-based therapy to DAA therapy. In the post-DAA-approval era, the untreated group was older, had a higher prevalence of HCC, and had less education than the treated group. Conclusions: More than 90% of CHC patients were over 40 years old, the major genotypes were 1b and 2, and IVDU was observed in less than 6% of CHC patients. Approximately half of the patients underwent antiviral therapy even in the DAA era, showing an unmet need with regard to HCV elimination. (Gut Liver 2020;14:207-217)

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“…HCV Research UK (HCVRUK) is a consortium of leading stakeholders in the UK, with a remit to address critical gaps in our understanding of the natural history of HCV‐related liver disease, effectiveness, and long‐term impact of antiviral treatment and genetic factors influencing prognosis . The HCVRUK clinical database and biobank were established in 2012 . We have recently published real‐world data on a decompensated cirrhosis HCVRUK cohort treated with DAA (UK Early Access Programme [EAP]) …”

Section: Introductionmentioning

confidence: 99%

Efficacy of direct‐acting antivirals: UK real‐world data from a well‐characterised predominantly cirrhotic HCV cohort

Macken

Gelson

Priest

et al. 2019

Journal of Medical Virology

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Direct-acting antivirals (DAAs) have revolutionised the management of chronic hepatitis C virus (HCV) infection. We describe UK real-world DAA experience. Individuals commencing HCV treatment containing a DAA regimen (participating in the National HCV Research UK (HCVRUK) Cohort Study were recruited from 33 UK HCV centers. The data were prospectively entered at sites onto a centralised database. The data were reported as median (Q1-Q3). Of the 1448 treated patients, 1054 (73%) were males, the median age being 54 years (47-60), 900 (62%) being genotype 1 and 455 (31%) genotype 3. The majority, 887 (61%) had cirrhosis, and 590 (41%) were treatment-experienced. DAA regimens utilised: genotype1 sofosbuvir (SOF)/Ledipasvir/±Ribavirin (625/900, 69%) and Ombitasvir/Paritaprevir/Dasabuvir/ ±RBV (220/900, 24%), and in genotype 3 SOF/Daclatasvir + RBV (256/455, 56%) and SOF/pegylated interferon/RBV (157/455, 35%). Overall, 1321 (91%) achieved sustained virological response (SVR12), genotype 1 vs 3, 93% vs 87%, P < .001. Prior treatment, presence of cirrhosis and treatment regimen did not impact SVR12. Predictors of treatment failure were genotype 3 infection, OR, 2.015 (95% CI: 1.279-3.176, P = .003), and male sex, OR, 1.878 (95% CI: 1.071-3.291, P = .028). Of those with hepatic decompensation at baseline (n = 39), 51% (n = 20) recompensated post-treatment, lower baseline serum creatinine being associated with recompensation (P = .029). There were two liver-related deaths, both having decompensated disease. This real-world UK data, comprising of a predominantly cirrhotic HCV genotype 1/3 cohort, confirms DAA efficacy with an overall 91% SVR12, with 51% recompensating post-treatment.Genotype 3 infection was a predictor of treatment failure.

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Cohort Profile: The Hepatitis C Virus (HCV) Research UK Clinical Database and Biobank

Cited by 27 publications

References 14 publications

The testing of people with any risk factor for hepatitis C in community pharmacies is cost‐effective

The testing of people with any risk factor for hepatitis C in community pharmacies is cost‐effective

Epidemiological and Clinical Characteristics of Hepatitis C Virus Infection in South Korea from 2007 to 2017: A Prospective Multicenter Cohort Study

Efficacy of direct‐acting antivirals: UK real‐world data from a well‐characterised predominantly cirrhotic HCV cohort

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