HCV Treatment With DAAs Reduces Liver-Related Hospitalizations in Cirrhosis

When hepatitis C virus (HCV) is treated successfully with direct-acting antivirals (DAAs), people with Child–Turquotte–Pugh (CTP) scores in the lower (CTP-A) and intermediate (CTP-B) ranges see a reduction in hospitalization rates and resource utilization costs, but people with more advanced scores (CTP-C) see no effect, according to the European Journal of Gastroenterology & Hepatology.

A study has indicated that DAAs are beneficial for people infected with HCV. Study authors sought to provide practice-driven data about direct-acting antivirals, liver-related hospitalizations, and costs utilization.

Using a retrospective cohort study design, researchers followed people receiving health care services from the University of California San Diego for chronic HCV infection with cirrhosis. Participants also had to be actively receiving care in the hepatology and liver transplant service.

Participants were compared based on whether they were treated with DAAs (n=196) or not (n=182). The primary outcomes for the study were incidence rates for liver-related hospitalizations as well as incidence rates for “hepatocellular carcinoma, liver transplant, and all-cause mortality.”

People who were not receiving direct-acting antiviral treatment had a higher incidence rate of liver-related hospitalizations than people who were treated with the therapy. The liver-related hospitalization incidence rates were 29.1/100 and 10.4/100 person-years of follow-up (P ≤ 0.0001) in the untreated and treated cohorts, respectively.

Participants with CTP-A (75.8%) and CTP-B (64.5%) experienced a decreased incidence of hospitalizations. None of these benefits were seen in people with more advanced hepatitis C-related cirrhosis.

Study authors also determined that DAAs could result in cost savings of between $1208 and $17,823.

Study limitations included a potential lead in bias, limited follow-up time, a relatively small sample size, and limited generalizability due to the study’s single-site design.

The study authors reported “treatment of [HCV] in patients with cirrhosis with [DAAs] resulted in a significant reduction in the incidence of liver-related hospitalizations and direct inpatient resource utilization in cirrhotic patients with CTP-A and CTP-B, but not in patients with CTP-C.”

Multiple authors declare affiliations with the pharmaceutical industry. Please refer to reference for a complete list of authors’ disclosures.

Reference

Hill LA, Delmonte RJ, Andrews B, et al. Treatment of hepatitis C with direct-acting antivirals significantly reduces liver-related hospitalizations in patients with cirrhosis [published on July 2, 2018]. European Journal of Gastroenterology & Hepatology. doi: 10.1097/MEG.0000000000001195