Comorbidities associated with the increasing burden of hepatitis C infection

Basseri, Benjamin; Yamini, David; Chee, Grace M.; Enayati, Pedram; Tran, Tram T.; Poordad, Fred

doi:10.1111/j.1478-3231.2010.02235.x

Cited by 54 publications

(35 citation statements)

References 68 publications

(81 reference statements)

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“…A small cross-sectional retrospective study investigating comorbidities associated with HCV from 1998 to 2007 found that HIV/AIDS, renal disease, diabetes, and obesity were more prevalent in patients with HCV compared with the U.S. population [27]. Higher comorbidity rates may reflect the selective age distribution of the HCV population, but there is also some recent evidence that comorbidity rates may be higher in the HCV population even after adjusting for age [17].…”

Section: Discussionmentioning

confidence: 99%

“…ICD-9 definitions, though applied from validated studies, may differ from other definitions such as the Clinical Classification Software from the U.S. Agency for Healthcare Research and Quality; this may partially account for slight differences in comorbidity rates observed in other reports [17, 27]. Medication use was explored in the chronic HCV cohort and not limited to treated patients, so conclusions should be drawn in this context.…”

Section: Discussionmentioning

confidence: 99%

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Medication use and medical comorbidity in patients with chronic hepatitis C from a US commercial claims database

Lauffenburger

Mayer

Hawke

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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Background With the advent of the direct-acting antiviral agents (DAAs), significant drug-drug interaction (DDI) potential now exists for patients treated for chronic hepatitis C virus (HCV) infection. However, little is known about how often patients with HCV use medications that may interact with newer HCV treatments, especially those with CYP3A DDI potential. Methods Using a large United States commercial insurance database, medication use and comorbidity burden was examined among adult patients with a chronic HCV diagnosis from 2006-2010. Medications were examined by total number of prescription claims, proportion of patients exposed, and DDI potential with prototypical CYP3A DAAs, boceprevir and telaprevir, for which data were available. Results Patient comorbidity burden was high and increased over the study period. Medication use was investigated in 53,461 patients with chronic HCV. Twenty-one (53%) of the top 40 most utilized medications were classified as having interaction potential, with 62% of patients received at least one of the top 22 interacting medications by exposure. Of these, 59% and 41% were listed in a common DDI resource but not in medication prescribing information, 77% and 77% had not been investigated in DDI studies, 32% and 27% did not have clear recommendations for DDI management, and only 14% and 23% carried a recommendation to avoid coadministration for boceprevir and telaprevir, respectively. Conclusion Practitioners may expect a medication with CYP3A DDI potential in two-thirds of patients with HCV and almost one-half of the most frequently used medications. However, DDI potential may not be reflected in prescribing information.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medication use and medical comorbidity in patients with chronic hepatitis C from a US commercial claims database

Lauffenburger

Mayer

Hawke

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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“…As fewer patients experience HIV-related morbidity and mortality, comorbidities and their associated consequences have consequently emerged as primary health concerns and are increasingly driving healthcare utilization and costs [3,4]. Coinfection with hepatitis C virus (HCV) is among the most important of these comorbidities.…”

Section: Introductionmentioning

confidence: 99%

HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality

et al. 2012

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ObjectivesHepatitis C virus (HCV) has emerged as an important health problem in the era of effective HIV treatment. However, very few data exist on the health status and disease burden of HIV/HCV-coinfected Canadians. MethodsHIV/HCV-coinfected patients were enrolled prospectively in a multicentre cohort from 16 centres across Canada between 2003 and 2010 and followed every 6 months. We determined rates of a first liver fibrosis or endstage liver disease (ESLD) event and all-cause mortality since cohort enrolment and calculated standardized mortality ratios compared with the general Canadian population. ResultsA total of 955 participants were enrolled in the study and followed for a median of 1.4 (interquartile range 0.5-2.3) years. Most were male (73%) with a median age of 44.5 years; 13% self-identified as aboriginal. There were high levels of current injecting drug and alcohol use and poverty. Observed event rates [per 100 person-years; 95% confidence interval (CI)] were: significant fibrosis (10.21; 8.49, 12.19), ESLD (3.16; 2.32, 4.20) and death (3.72; 2.86, 4.77). The overall standardized mortality ratio was 17.08 (95% CI 12.83, 21.34); 12.80 (95% CI 9.10, 16.50) for male patients and 28.74 (95% CI 14.66, 42.83) for female patients. The primary causes of death were ESLD (29%) and overdose (24%).

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“…Compared to the general US population, ESRD was found to be 13-fold more common among individuals infected with HCV [21]. A recent multicentric French survey found a similar prevalence (7.8%) of anti-HCV antibodies in HD patients from 56 units [22].…”

Section: Epidemiologymentioning

confidence: 92%

Hepatitis C Virus and End Stage Renal Disease

Gutiérrez

Patton

2011

Curr Hepatitis Rep

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Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease in the world. It is particularly common in patients with end-stage renal disease (ESRD), both due to risk for chronic kidney disease related to HCV infection and risk for HCV infection acquisition in the hemodialysis population. In the United States, nosocomial risk of HCV has diminished, but this continues to be a major challenge in the developing world. Current available HCV therapies are more complex and less efficacious in the setting of ESRD. In the setting of donor organ shortage, transplant specialists must weigh the risks and benefits of using donor kidneys from patients positive for HCV antibody. The goal of this review is to update the reader on significant findings in HCV and ESRD. The major topics covered include updates in epidemiology, natural history, HCV treatment, and transplantation.

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Comorbidities associated with the increasing burden of hepatitis C infection

Abstract: HCV poses an increasing healthcare burden associated with increased prevalence of diabetes, obesity, HIV, ESRD, maladaptive lifestyle habits and poor quality of life. Practitioners should be cognizant of these trends in order to appropriately manage these comorbidities.

Cited by 54 publications

References 68 publications

Medication use and medical comorbidity in patients with chronic hepatitis C from a US commercial claims database

Medication use and medical comorbidity in patients with chronic hepatitis C from a US commercial claims database

HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality

Hepatitis C Virus and End Stage Renal Disease

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