Comorbidities and co-medications in populations with and without chronic hepatitis C virus infection in Japan between 2015 and 2016

Abstract

BackgroundDirect-acting anti-viral agents have improved the treatment of chronic hepatitis C virus (HCV) infection, but this treatment is challenging for patients using co-medications because of potential drug–drug interactions. This study aimed to examine the comorbidities and co-medications of Japanese chronic HCV patients by age group, compared with a non-HCV patient population.MethodsThis was a retrospective observational study using a hospital-based medical claims database. We extracted data of patients with chronic HCV aged ≥18 years, and age-, sex-, and hospital-matched patients without HCV, for the period from January 2015 to November 2016, and then examined chronic comorbidities, long-term co-medications, and medications prescribed at least once during the study period.ResultsWe analysed data from 128,967 chronic HCV patients and 515,868 non-HCV patients. The median age was 70 years, and 51.0% of patients were male. More chronic HCV patients than non-HCV patients (70.5% vs. 47.1%) had at least one comorbidity, and older patients had more comorbidities than younger patients. The most common comorbidities in chronic HCV patients were diseases of oesophagus, stomach and duodenum (41.7%), followed by hypertensive diseases (31.4%). Chronic HCV patients used co-medications more commonly than non-HCV patients, and older patients used more co-medications. The most common long-term co-medications in chronic HCV patients were proton pump inhibitors (14.0%), which were prescribed to 31.9% of chronic HCV patients at least once during the study period.ConclusionsPatients with chronic HCV in Japan had more comorbidities than patients without chronic HCV regardless of age. Particularly older patients, who constitute the majority of the HCV patient population in Japan, commonly had multiple comorbidities and used co-medications. To optimise HCV treatment, physicians need to know the exact medication profiles of patients and take appropriate action to manage drug–drug interactions.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3148-z) contains supplementary material, which is available to authorized users.

HCV-Infected Individuals have Higher Prevalence of Comorbidity and Multimorbidity: A retrospective cohort study

“…We also did not find evidence of increased prevalence of any cardiovascular conditions among people with HCV compared to the general population, including both acute (myocardial infarction, stroke) or chronic (hypertension, chronic coronary syndrome, congestive heart failure, arrhythmia) conditions. This is in contrast to other studies that found increased prevalences of these conditions among people with HCV [10,12,13,16], although, again, our condition ascertainment was more rigorous. Again, we note that the comparator studies used a variety of ascertainment methods for defining comorbidity, the majority of which have not been validated, or included symptom-based diagnoses such as pain, making comparisons challenging.…”

“…This was true for conditions known to have causal relationships with HCV, including diabetes, some cancers, and chronic renal failure [5][6][7], although our estimates for these conditions were generally lower than those in other studies with less stringent, unvalidated methods of chronic disease ascertainment [10,13,14,16] or from clinical charts. [11] We also found greater prevalence of lung conditions including asthma and COPD, which were, when combined, higher than some [10,13] and lower [16] than prevalences reported in studies with less robust definitions, likely due to overlap between these conditions and their relationship with smoking. We also did not find evidence of increased prevalence of any cardiovascular conditions among people with HCV compared to the general population, including both acute (myocardial infarction, stroke) or chronic (hypertension, chronic coronary syndrome, congestive heart failure, arrhythmia) conditions.…”

“…[5][6][7] With others, the association is related to common risk factors including smoking, excess alcohol use, recreational drug use, and poverty. [8,9] To date, a few studies have comprehensively evaluated comorbidity among people with HCV, with previous work focused on a limited array of diagnoses or generated clinical cohort [10][11][12][13] or insurance claims data [14][15][16] pointing to increased prevalence of several individual conditions. We found only one study examining the presence of multiple comorbidities among this population, although ascertainment of chronic conditions were not validated.…”

HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study

“…These studies showed significant comorbidities such as diabetes, dyslipidaemia and hypertension amongst HCV patients, but did not report on multiple comorbidities. Liu et al [28] reported on multiple comorbidities in their study of Taiwanese adult HCV patients using a physician-completed survey, as did Ruzicka et al [29] in their study of Japanese adult HCV patients using a medical claims database and Louie et al [30] in their study of patients with chronic HCV using a US medical claims database. All of these studies showed a significant prevalence of multiple comorbidities (e.g., more than 50% of Japanese HCV patients had ≥4 comorbidities, and 52% of US patients reported [6][7][8][9][10][11][12][13][14][15], with the latter two showing this to be greater than amongst matched controls (e.g., only 29.5% of Japanese non-HCV patients had ≥4, and over 47% of US patients reported ≤5 comorbidities).…”

Leveraging machine learning and big data for optimizing medication prescriptions in complex diseases: a case study in diabetes management

“…Their study confirmed the potential impact of coexisting diseases and multiple medications on the efficacy of treatment and highlighted the research gap in developing treatment policies that take both factors into account. Research groups led by Utz and Ruzicka [16,17] investigated the difficulty of treatment for patients with Gaucher disease Type 1 and chronic hepatitis C virus, respectively. Both studies emphasized the need to optimize medication treatment strategies for such complex diseases.…”