Natural history of liver‐related disease in patients with chronic hepatitis C virus infection: An analysis using a Markov chain model

Abstract

Background Long‐term prognosis of patients with chronic hepatitis C infection (HCV) remains incompletely characterized. We investigated the long‐term prognosis of liver disease in patients with chronic HCV infection who have not received antiviral therapy. Methods A total of 2304 patients with chronic HCV who were not received interferon‐based therapy were included. Results In the assessment of 1‐year disease state of liver transition probabilities, progression to chronic hepatitis occurred in 12% to 14% of patients across all age groups in male asymptomatic carriers. In male patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (7.6%) and ≥70 age groups (9.6%). In addition, in male patients with cirrhosis, HCC development occurred in approximately 5% of patients over the age of 40. In female asymptomatic carriers, progression to chronic hepatitis was observed in 6% to 14% of patients across all age groups. In female patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (8.7%) and ≥70 (7.4%) age groups. In addition, in female patients with cirrhosis, HCC development occurred in 0.9% to 3.3% of patients over the age of 50. Under assumptions of either chronic hepatitis or asymptomatic carrier state at age 40 as the starting condition for simulation over the following 40 years, the probability of HCC gradually increased with age and was higher in male patients. Conclusions There is a risk of cirrhosis or HCC development in HCV patients with not only chronic hepatitis but the asymptomatic carrier state as well.

Direct-acting antivirals improve survival and recurrence rates after treatment of hepatocellular carcinoma within the Milan criteria

“…Hepatitis C virus (HCV) infection affects an estimated 1.8 million people globally and is the leading cause of hepatocellular carcinoma (HCC) [ 1 ]. Reports have indicated that the most serious outcome of HCV infection is hepatocarcinogenesis or progressive hepatic failure resulting in death [ 2 ], and that HCV infection increases the rate of complications associated with extrahepatic morbidity, which accounted for about 50% of the HCV deaths [ 3 ].…”

Comparison of liver disease state progression in patients with eradication of versus persistent infection with hepatitis C virus: Markov chain analysis

“…In particular, we simulated the per cent probabilities of transition across liver states over the long term in patients with chronic hepatitis or cirrhosis at age 40 and 60, stratified by sex and HCV eradication status. Although we did not perform a validation analysis in this study, we have extensively studied 42‐47 long‐term prognosis in patients with chronic hepatitis B virus and HCV infection in other several cohorts using Markov chain model simulation. Therefore, we strongly believe that Markov chain models are accurate and useful for simulating the prognosis of chronic hepatitis infection.…”

Estimation of The Transitional Probability Among Esophageal Cancer and Its Precancerous Lesions

“…Markov model is a useful method to describe the process of individuals passing through a series of states in continuous time. These types of patterns explain how patients transition between long-term disease states, which is popular in explaining the natural history of disease [38,39]. Moreover, the Markov model has another advantage that it can utilize data with limitation in quality and accuracy, which may be collected retrospectively [40].…”