Epidemiology of hepatitis C virus infection in a large Israeli health maintenance organization

Abstract

Hepatitis C affects an estimated 130 million people worldwide and is a major cause of chronic liver disease. This retrospective database study aims to describe the epidemiology of HCV-infected patients in Maccabi Healthcare Services, a 2-million-member health maintenance organization in Israel. HCV was identified by cross-linking diagnoses, laboratory data, and dispensed HCV treatment (1993-2013). The point-prevalence of HCV in 2012 and annual incidence of newly-diagnosed HCV during 2003-2012 (index period) were calculated. The age-adjusted prevalence of HCV was 5.19/1,000 population (n = 10,648). The highest prevalence was found among males and in patients aged 35-54 years. Two thirds of HCV-infected patients were immigrants from the former Soviet Union (FSU). HCV genotype 1 was predominant (67%). A total of 6,150 patients were newly diagnosed with HCV infection during the index period. The age-standardized rate of newly-diagnosed HCV declined from over 50/100,000 (2003) to 15/100,000 (2012). This rate was highest in males from the FSU, particularly for birth cohorts in 1950-70. The study results suggest that the reported incidence of HCV infection in Israel is declining, while prevalence is particularly high among FSU immigrants and genotype 1 is predominant. As the HCV treatment landscape evolves, these estimates can inform future studies and health technology assessments.

Sustained virological response to ombitasvir/paritaprevir/ritonavir and dasabuvir treatment for hepatitis C: Real‐world data from a large healthcare provider

“…Hepatitis C virus genotype 1 (GT1) is the most prevalent genotype globally, 2 including in Israel. 3 Achieving a sustained virological response with antiviral therapy (SVR, defined as undetected HCV RNA measured at 12-or 24-week post-treatment) is associated with lower risk of developing hepatocellular cancer (HCC) 4 and lower all-cause mortality in patients with advanced fibrosis. 5 With the prior standard of care HCV therapy of pegylated interferon combined with ribavirin, however, less than half of GT1 patients achieved SVR, and real-world evidence underscores the suboptimal adherence to this regimen.…”

“…Hepatitis C virus genotype 1 (GT1) is the most prevalent genotype globally, including in Israel . Achieving a sustained virological response with antiviral therapy (SVR, defined as undetected HCV RNA measured at 12‐ or 24‐week post‐treatment) is associated with lower risk of developing hepatocellular cancer (HCC) and lower all‐cause mortality in patients with advanced fibrosis .…”

Multi-disciplinary patient-centered model for the expedited provision of costly therapies in community settings: the case of new medication for hepatitis C

“…MHS members share similar demographic characteristics to the general population and represent a quarter of the national population (with minor difference related to higher average income and a greater proportion of new immigrants) [ 7 ]. In 2012, a total of 10,948 MHS members had a record of HCV infection, the majority of which were immigrants from the Former Soviet Union [ 8 ]. HCV GT1 is predominant in Israel [ 2 , 8 ].…”

“…In 2012, a total of 10,948 MHS members had a record of HCV infection, the majority of which were immigrants from the Former Soviet Union [ 8 ]. HCV GT1 is predominant in Israel [ 2 , 8 ]. This article describes the experience delivering HCV treatment in the MHS Central district, which is one of five geographical administrative districts and is comprised of 14 sub-districts and 21 branches, with approximately 476,000 members and 192 family physicians in 2015.…”

HCV Genotype-1 Subtypes and Resistance-Associated Substitutions in Drug-Naive and in Direct-Acting Antiviral Treatment Failure Patients

“…GT1 accounts for more than 70% of Israel's HCVinfected patients, two-thirds of whom are immigrants from the former Soviet Union (FSU) [6,7]. HCV genotype is determined using commercial assays (Abbott m2000 Real-Time HCV Genotype II assay; Abbott Molecular Inc., Des Plaines, IL, USA or the VERSANT HCV Genotype Assay, LiPA 2.0; Siemens, Tarrytown, NY, USA), which were found to be limited in their genotyping and subtyping capabilities [8][9][10] and in their sensitivity toward recombinant viruses [11].…”