Epidemiological, demographic and clinical data on chronic viral hepatitis C in Tuscany

Stasi, Cristina; Silvestri, Caterina; Berni, Roberto; Brunetto, M.R.; Zignego, Anna Linda; Orsini, Cristina; Milani, Stefano; Ricciardi, Liana; Luca, Andrea De; Blanc, Pierluigi; Nencioni, Cesira; Aquilini, Donatella; Bartoloni, Alessandro; Bresci, G.; Marchi, Santino; Filipponi, Franco; Colombatto, P.; Forte, Paolo; Galli, Andrea; Luchi, Sauro; Chigiotti, Silvia; Nerli, A; Corti, Giampaolo; Sacco, Rodolfo; Carrai, P; Ricchiuti, Angelo; Giusti, Massimo; Almi, P; Cozzi, Andrea; Carloppi, Silvia; Voller, Fabio; Cipriani, Francesco

doi:10.1080/03007995.2018.1482264

Cited by 9 publications

(12 citation statements)

References 14 publications

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“…This was true for conditions known to have causal relationships with HCV, including diabetes, some cancers, and chronic renal failure [5][6][7][8][9][10][15][16][17][18][19], although our estimates for these conditions were generally lower than those in other studies with less stringent, unvalidated methods of chronic disease ascertainment [26,27,29,30] or from clinical charts [25]. For example, we found the prevalence of diabetes in our cohort was 13.27%, compared to 13.8-26.1% in other studies [25-27, 29, 30].…”

Section: Discussioncontrasting

confidence: 71%

“…To date, there are a limited number of studies that have comprehensively evaluated comorbidity among people with HCV. For example, Stasi et al [25] used a studyspecific clinical database for patients from 16 hospitals in Tuscany to look at comorbidities amongst HCV patients, Sicras-Mainar et al [26] conducted a similar study based on medical records at 8 primary care centres in Spain, and Lauffenburger et al [27] used a US commercial claims database for the same purpose. These studies showed significant comorbidities such as diabetes, dyslipidaemia and hypertension amongst HCV patients, but did not report on multiple comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Background: Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment uptake and cure in the pre-and post-direct acting antiviral (DAA) era. Methods: We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age-and sex-standardized rates of comorbidity and comparisons were made by interferon-based and interferon-free, DAA HCV treatments. Results: The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29-3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated. Conclusion: People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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show abstract

“…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.…”

Section: Discussionmentioning

confidence: 37%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

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

Cooper

Galanakis

Donelle

et al. 2019

Preprint

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Background Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment in the pre- and post-direct acting antiviral (DAA) era. Methods We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age- and sex-standardized rates of comorbidity and comparisons were made by interferon-based and DAA HCV treatments. Results The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29 – 3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated. Conclusion People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.

show abstract

“…[23,24] To date, there are a limited number of studies that have comprehensively evaluated comorbidity among people with HCV. For example, Stasi et al [25] used a study-specific clinical database for patients from 16 hospitals in Tuscany to look at comorbidities amongst HCV patients, Sicras-Mainar et al [26] conducted a similar study based on medical records at 8 primary care centres in Spain, and Lauffenburger et al [27] used a US commercial claims database for the same purpose. These studies showed significant comorbidities such as diabetes, dyslipidaemia and hypertension amongst HCV patients, but did not report on multiple comorbidities.…”

mentioning

confidence: 99%

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

Cooper

Galanakis

Donelle

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment uptake and cure in the pre- and post-direct acting antiviral (DAA) era. Methods: We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age- and sex-standardized rates of comorbidity and comparisons were made by interferon-based and interferon-free, DAA HCV treatments. Results: The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29 – 3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated. Conclusion: People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.

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Epidemiological, demographic and clinical data on chronic viral hepatitis C in Tuscany

Abstract: Our study provides evidence of a high prevalence of epidemiological changes in HCV infection with a major prevalence of advanced liver disease, such as portal hypertension, in this elderly cohort of patients.

Cited by 9 publications

References 14 publications

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

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

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

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

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