Real-World Clinical Outcomes among Individuals with Chronic HCV Infection in China: CCgenos Study

Abstract

Background: This 5-year follow-up of the CCgenos cross-sectional study aimed to observe real-life outcomes in a cohort of 997 Han Chinese patients with chronic HCV infection and to explore the impacts of HCV genotype, patient characteristics and treatment status. Methods: Clinical information and centralized HCV RNA measures were collected every 6/3 months for untreated/ treated patients. Overall disease progression was defined as ≥1 of: de novo development of cirrhosis, Child-Turcotte-Pugh score increased by ≥2 points (if cirrhosis at baseline), progression to decompensated cirrhosis, hepatocellular carcinoma (HCC), liver transplant or death. Cox regression assessed risk factors for the time from estimated infection to cirrhosis or HCC. Logistic regression assessed risk factors for incidence rates of cirrhosis and overall disease progression. Results: 281 of 514 patients enrolled across China completed 5 years of follow-up. Overall disease progression occurred in 36/364 (9.9%) treated patients and 35/148 (23.6%) untreated patients (odds ratio = 0.35; 95% CI 0.21, 0.59; P<0.0001). Overall disease progression occurred in 6/231 (2.6%) patients achieving sustained virological response at 24 weeks (SVR24) versus 11/82 (13.4%) who did not (P=0.0002). Cirrhosis development was significantly associated with abnormal aspartate aminotransferase (AST), age ≥40 years, body mass index ≥28 kg/m 2 , HCV GT1, platelet count <100×10 9 /l, and AST to platelet ratio index (APRI) ≥2 (multivariate Cox regression, P<0.05). HCC was significantly associated with HCV GT1 and platelet count <100×10 9 /l (multivariate Cox regression, P<0.05). Conclusions: Achieving SVR24 significantly reduced the probability of overall disease progression but no significant difference was seen for both cirrhosis and HCC during 5 years of follow-up.Chronic HCV (cHCV) infection presents a major global public health burden [1,2]: the current estimate of global prevalence is 71 million [1,2]. The development of highly effective, well-tolerated, direct-acting antivirals (DAAs) has changed the treatment landscape for HCV, but global availability of these agents has been limited [1]. More than half of the world's HCV-infected population is in Asia [3]. In China, the

Prevalence and characteristics of hepatitis C virus infection in Shenyang City, Northeast China, and prediction of HCV RNA positivity according to serum anti-HCV level: retrospective review of hospital data

“…In line with previous reports showing a difference in anti-HCV-positive rates between sexes [22][23][24][25], the positive rates of both serum anti-HCV and HCV RNA in male patients were significantly higher than those in female patients in the current study. Although the precise reasons for this difference in prevalence of HCV infection according to sex are not yet clear, it may be related to different life styles, such as male homosexuality, sharing of equipment used for drug injection, and tattoo, and thus men may have a higher chance of being infected by HCV [26].…”

Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China

“…An additional 23 patients were excluded because they were unable to complete the intact HRQoL assessment, leaving 456 patients for the final analysis. During the follow-up period, joining other clinical studies related to Hepatitis C, loss to follow-up, withdrawal of informed consent, or missing certain visits can all lead to a reduction in the annual count of enrolled patients [ 14 ]. The sociodemographic characteristics of the patients are summarized in Table 1 , with a median age of 46.5 years (interquartile range: 36.5–57.0) and 57.5% males.…”

“…Patients without complete data about HRQoL were also excluded. No other exclusion criteria were applied for the follow-up phase, and no randomization or protocol-driven treatment was implemented [ 14 ]. The study protocols were approved by a central review board (the ethics committee of Peking University People’ s Hospital), the institutional review boards of each participating center, and the China National Human Genetic Resource Management Office (2010).…”

Distribution of hepatitis C virus genotype and subtype between Mongolian and Han in Inner Mongolia

“…Mongolian individuals may have a greater likelihood of being infected with HCV. [ 19 , 20 ] Another possibility is closely related to the genetic background and autoimmune status of HCV-infected individuals. [ 21 , 22 ] Single nucleotide polymorphism in the human leukocyte antigen alleles may play an important role in immune-mediated diseases, including liver cancer.…”