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One Hepatitis C Genotype Puts Patients at Greater Risk for Liver Disease

FEB 10, 2017 | CONTAGION EDITORIAL STAFF
A recent study from US researchers suggests that liver disease severity and treatment costs for people with hepatitis C (HCV) vary depending on a patient’s genotype.

HCV is a viral infection that may result in inflammation of the liver. While infection with HCV can be mild, more chronic forms of infection can result in lifelong liver disease. A recent study from Israel found that systemic lupus erythematosus (SLE) may increase the risk of chronic HCV. The findings show that patients with SLE were three times more likely to develop chronic HCV than those in the control group. Although prior studies have shown a higher rate of HCV infection in patients with SLE, previous studies had significantly smaller patient cohorts.

In the US study, researchers analyzed data from selected health insurance claims in the United States, and identified varying disease progression and healthcare costs based on genotype.

“This study provides evidence of variation by HCV genotype in liver and non-liver related comorbidities, liver disease severity, and healthcare costs,” the authors wrote in the journal Current Medical Research and Opinion.

Chronic HCV infection can cause serious liver damage, cirrhosis, and may also lead to liver cancer. There are six major strains, or genotypes, of the virus. While genotype 1 is the most prevalent in the United States, genotype 3 appears to be the most difficult to treat.

The retrospective study collected data on patient demographic and clinical characteristics provided in healthcare claims from a large US health plan. All patients had at least 18 months of a continuous pharmacy and medical insurance. Potential participants were excluded if age, sex, geographic region, and health insurance were unknown.

Approximately 64% of the patients were male with an average age of around 50.6 years. Out of the more than 10,000 patients included in the review, 79.1% had genotype 1, 12.8% had genotype 2, and 8.1% had genotype 3.

The study found that patients with genotype 3 had the highest percentage of liver-related comorbidities and advanced liver disease. They were about one-third times more likely to have advanced liver disease than were patients with genotype 1 of the virus. The highest rates of steatosis, liver transplant, and hepatocellular carcinoma (the most common form of liver cancer) were also found to be among patients with genotype 3.

“These findings support the notion that genotype 3 variant of the virus imparts a unique pathophysiology throughout the disease course,” the authors stated, also noting that the findings were similar to previous studies.

Those with genotype 1 took the hardest financial hit with the highest all-cause costs, while patients with genotype 2 had the lowest costs and lower healthcare resource utilization.

“These differences may reflect differing rates of non-liver-related comorbidities and all-cause care,” the authors explained. “Multivariable analyses showed that genotype was a significant predictor of costs and liver disease severity: compared with patients having genotype 1, those with genotype 3 were significantly more likely to have advanced liver disease. Patients with genotype 2 were significantly less likely to have advanced disease and more likely to have lower all-cause costs.”

One limitation of the study is that results may not generally represent other patients outside the insurance plans from which data was analyzed, the authors noted.

“The findings highlight the importance of effective HCV treatment for all patients and support guidelines for treatment of high-risk patients,” including patients with genotype 3 of the virus, the team concluded.
 
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A recent study from US researchers suggests that liver disease severity and treatment costs for people with hepatitis C (HCV) vary depending on a patient's genotype.