Treatment for Hepatitis C Virus in Human Immunodeficiency Virus–Infected Patients

Kuehne, Felicitas; Bethe, Ullrich; Freedberg, Kenneth A.; Goldie, Sue J.

doi:10.1001/archinte.162.22.2545

Cited by 42 publications

(60 citation statements)

References 160 publications

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“…A second full paper was identified on searching the references of the included study, and this study met the inclusion criteria. Therefore, two full economic evaluations 64,65 met the inclusion criteria for the review. The study characteristics are presented in Table 9.…”

Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

“…An additional interferon alfa monotherapy arm was included in the Kuehne and colleagues study. 64 Kuehne and colleagues 64 present a cost-utility analysis, while in the more recent Campos and colleagues paper 65 a cost-effectiveness analysis is reported.…”

Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

“…Kuehne and colleagues 64 cite several sources for the treatment efficacy measure. The study by Kuehne and colleagues 64 was conducted prior to the publication of trials of antiviral treatment in co-infected patients. The treatment efficacy measure therefore comes from studies of the treatment of mono-infected patients, and should therefore be viewed with caution.…”

Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

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Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Hartwell

Jones²,

Baxter³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAPeginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a...

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Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

Section: Quantity and Quality Of The Research Availablementioning

confidence: 99%

See 1 more Smart Citation

Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Hartwell

Jones²,

Baxter³

et al. 2011

Health Technol Assess

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“…Kuehne et al demonstrated that combination therapy for histologically moderate HCV in co-infected patients resulted in an increase in quality-adjusted life expectancy while incurring costs comparable with other wellaccepted clinical interventions. 16 However, this analysis was performed before randomized controlled trials had established approximate treatment efficacy rates in HIV-HCV co-infected patients, and the APRICOT trial rates of sustained virologic response were generally lower than the lower bounds of the sensitivity analysis performed by Kuehne and colleagues. Since this prior cost-effectiveness analysis was conducted, considerable progress has been made in discerning treatment efficacy rates and relative risk estimates for progression of liver disease in HIV-HCV co-infected patients.…”

mentioning

confidence: 99%

Cost-effectiveness of Treatment for Hepatitis C in an Urban Cohort Co-infected with HIV

Campos

Salomon

Servoss

et al. 2007

The American Journal of Medicine

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PURPOSE-Recent clinical trials have evaluated treatment strategies for chronic infection with hepatitis C virus (HCV) in patients co-infected with human immunodeficiency virus (HIV). Our objective was to use these data to examine the cost-effectiveness of treating HCV in an urban cohort of co-infected patients.METHODS-A computer-based model, together with available published data, was used to estimate lifetime costs (2004 US dollars), life expectancy, and incremental cost per year of life saved (YLS) associated with 3 treatment strategies: (1) interferon-alfa and ribavirin; (2) pegylated interferon-alfa; and (3) pegylated interferon-alfa and ribavirin. The target population included treatment-eligible patients, based on an actual urban cohort of HIV-HCV co-infected subjects, with a mean age of 44 years, of whom 66% had genotype 1 HCV, 16% had cirrhosis, and 98% had CD4 cell counts >200 cells/mm 3 .RESULTS-Pegylated interferon-alfa and ribavirin was consistently more effective and costeffective than other treatment strategies, particularly in patients with non-genotype 1 HCV. For patients with CD4 counts between 200 and 500 cells/mm 3 , survival benefits ranged from 5 to 11 months, and incremental cost-effectiveness ratios were consistently less than $75,000 per YLS for men and women of both genotypes. Due to better treatment efficacy in non-genotype 1 HCV patients, this group experienced greater life expectancy gains and lower incremental cost-effectiveness ratios.CONCLUSIONS-Combination therapy with pegylated interferon-alfa and ribavirin for HCV in eligible co-infected patients with stable HIV disease provides substantial life-expectancy benefits Requests and appears to be cost-effective. Overcoming barriers to HCV treatment eligibility among urban coinfected patients remains a critical priority. KeywordsHepatitis C virus (HCV); Human immunodeficiency virus (HIV); Cost-effectiveness; Peginterferonalfa and ribavirin; Clinical guidelines; Treatment eligibility Among the estimated 950,000 persons infected with human immunodeficiency virus (HIV) in the United States, approximately 30% are co-infected with the hepatitis C virus (HCV). 1,2 While highly active antiretroviral therapy (HAART) has essentially transformed HIV to a chronic disease, co-infected patients are increasingly vulnerable to complications of chronic liver disease, including cirrhosis and liver failure. Compared with HCV mono-infected patients, they tend to have higher levels of HCV RNA and to progress more rapidly to cirrhosis and end-stage liver disease. 3 Mortality attributable to end-stage liver disease has steadily increased since 1996, and in some HIV patient populations it is now the leading cause of death. 4 The impact of HCV on HIV progression is more controversial. 5-7 CLINICAL SIGNIFICANCE• In patients infected with both HIV and HCV, therapy with pegylated interferonalfa and ribavirin for HCV increases life-expectancy and appears to be costeffective.In clinical trials among patients with HCV mono-infection, combination therapy ...

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“…Os critérios considera- Hepatite crônica para cirrose compensada 0,073 0,037-0,146 Kuehne et al 30 Hepatite crônica para hepatocarcinoma 0,001 0,0005-0,0017 Kuehne et al 30 ; El Saadany et al 31 Cirrose para ascite 0,025 0,012-0,05 Vianna et al 14 ; Bennett et al 32 Ascite para ascite refratário 0,067 0,034-0,14 Vianna et al 14 Cirrose compensada para encefalopatia hepática 0,004 0,002-0,008 Bennett et al 32 ; Goulart 33 Cirrose para hepatocarcinoma 0,015 0,01-0,07 Kuehne et al 30 ; Goulart 33 Cirrose compensada para hemorragia gastrointestinal 0,011 0,005-0,02 Vianna et al 14 ; Bennett et al 32 Morte encefalopatia hepática no primeiro ano 0,680 0,34-0,90 Bennett et al 32 Morte encefalopatia hepática anos subsequentes 0,400 0,2-0, Morte associada à espera por transplante 0,102 0,05-0,20 Vianna et al 14 ; Fink et al 34 Figura 1…”

Section: Métodosunclassified

Custo-efetividade da inclusão dos respondedores virológicos lentos no tratamento da hepatite C na presença da coinfecção com o HIV

et al. 2013

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Evidências recentes demonstram que respondedores virológicos lentos podem se beneficiar com a extensão do tratamento antiviral. O estudo investigou a adoção desse protocolo diante da coinfecção VHC/HIV. O objetivo foi estudar a relação de custo/efetividade da terapêutica com peguinterferon associado à ribavirina em portadores do genótipo 1 do VHC coinfectados com o HIV, comparando-se a inclusão ou não de respondedores virológicos lentos. Simulou-se por meio de um modelo de Markov a progressão da doença hepática em uma coorte hipotética de mil homens, maiores de 40 anos, considerandose a perspectiva do Sistema Único de Saúde (SUS) e horizonte temporal de 30 anos. A extensão do tratamento para respondedores lentos resultou em uma razão incremental de custo efetividade de R$ 44.171/QALY, valor abaixo do limiar de aceitabilidade proposto pela Organização Mundial da Saúde. A análise de sensibilidade não modificou os resultados alcançados. A inclusão de indivíduos coinfectados VHC/HIV respondedores virológicos lentos no protocolo de tratamento apresenta-se como uma estratégia custo-efetiva para o SUS.

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Treatment for Hepatitis C Virus in Human Immunodeficiency Virus–Infected Patients

Abstract: Combination therapy for moderate hepatitis in coinfected patients will increase quality-adjusted life expectancy and have a cost-effectiveness ratio comparable to that of other well-accepted clinical interventions.

Cited by 42 publications

References 160 publications

Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Cost-effectiveness of Treatment for Hepatitis C in an Urban Cohort Co-infected with HIV

Custo-efetividade da inclusão dos respondedores virológicos lentos no tratamento da hepatite C na presença da coinfecção com o HIV

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