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Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany?

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Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany? / Bischoff, Jenny; Boesecke, Christoph; Ingiliz, Patrick; Berger, Florian; Simon, Karl-Georg; Lutz, Thomas; Schewe, Carl K; Schulze Zur Wiesch, Julian; Hueppe, Dietrich; Christensen, Stefan; Mauss, Stefan; Baumgarten, Axel; Rockstroh, Jürgen K; GECCO Consortium.

In: J CLIN GASTROENTEROL, Vol. 54, No. 2, 02.2020, p. 192-199.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Bischoff, J, Boesecke, C, Ingiliz, P, Berger, F, Simon, K-G, Lutz, T, Schewe, CK, Schulze Zur Wiesch, J, Hueppe, D, Christensen, S, Mauss, S, Baumgarten, A, Rockstroh, JK & GECCO Consortium 2020, 'Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany?', J CLIN GASTROENTEROL, vol. 54, no. 2, pp. 192-199. https://doi.org/10.1097/MCG.0000000000001189

APA

Bischoff, J., Boesecke, C., Ingiliz, P., Berger, F., Simon, K-G., Lutz, T., Schewe, C. K., Schulze Zur Wiesch, J., Hueppe, D., Christensen, S., Mauss, S., Baumgarten, A., Rockstroh, J. K., & GECCO Consortium (2020). Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany? J CLIN GASTROENTEROL, 54(2), 192-199. https://doi.org/10.1097/MCG.0000000000001189

Vancouver

Bischoff J, Boesecke C, Ingiliz P, Berger F, Simon K-G, Lutz T et al. Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany? J CLIN GASTROENTEROL. 2020 Feb;54(2):192-199. https://doi.org/10.1097/MCG.0000000000001189

Bibtex

@article{1da37dadd2014f648cd906d55a37c3b6,
title = "Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany?",
abstract = "GOALS AND BACKGROUND: International guidelines recommend prioritized treatment initiation in hepatitis C virus (HCV)-infected patients with advanced liver disease. We aimed to evaluate whether the widespread usage of direct acting antivirals (DAAs) has led to a decrease in late presentation for care.STUDY: Data derived from the multicenter German Hepatitis C Cohort (GECCO) was analyzed. Treatment naive HCV-infected patients initiating DAA-based treatment between January 2014 and September 2017 were included. Advanced liver disease was defined by aspartate aminotransferase to platelet ratio index score ≥1.5, METAVIR≥F3, or FibroScan ≥9.5 kPa. Period prevalence and risk factors for late presentation were evaluated.RESULTS: Six hundred fifty-three HCV-monoinfected and 210 HIV/HCV-coinfected patients (mean age, 48.6±12.7 y; 65.5% male) were included. Overall 32.5% of patients had advanced liver disease. In 2014 39.4% of patients presented with advanced liver disease, decreasing to 30.1%, 34.4%, and 26.4% in the years 2015, 2016, and 2017 (P=0.057), respectively. Patients with and without advanced liver disease differed in age (P<0.0001), CD4 ≤350/µL (P=0.027), genotype (P=0.005), transmission route (P=0.047), body mass index (P<0.001), and time since diagnosis (P=0.007). In the multivariable binary logistic regression analysis GT3, age above 45 years and being diagnosed >2 years ago were positively and HCV transmission through men who have sex with men was negatively associated with advanced liver disease.CONCLUSIONS: Overall 32.5% of patients presented with advanced liver disease. We observed a trend toward a lower proportion of patients starting treatment late.GT3, age, years since HCV diagnosis and HCV transmission route were identified as risk factors for presentation with advanced liver disease.",
author = "Jenny Bischoff and Christoph Boesecke and Patrick Ingiliz and Florian Berger and Karl-Georg Simon and Thomas Lutz and Schewe, {Carl K} and {Schulze Zur Wiesch}, Julian and Dietrich Hueppe and Stefan Christensen and Stefan Mauss and Axel Baumgarten and Rockstroh, {J{\"u}rgen K} and {GECCO Consortium}",
year = "2020",
month = feb,
doi = "10.1097/MCG.0000000000001189",
language = "English",
volume = "54",
pages = "192--199",
journal = "J CLIN GASTROENTEROL",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

RIS

TY - JOUR

T1 - Has Increased Rollout of Direct Acting Antiviral Therapy Decreased the Burden of Late Presentation and Advanced Liver Disease in Patients Starting Hepatitis C Virus Therapy in Germany?

AU - Bischoff, Jenny

AU - Boesecke, Christoph

AU - Ingiliz, Patrick

AU - Berger, Florian

AU - Simon, Karl-Georg

AU - Lutz, Thomas

AU - Schewe, Carl K

AU - Schulze Zur Wiesch, Julian

AU - Hueppe, Dietrich

AU - Christensen, Stefan

AU - Mauss, Stefan

AU - Baumgarten, Axel

AU - Rockstroh, Jürgen K

AU - GECCO Consortium

PY - 2020/2

Y1 - 2020/2

N2 - GOALS AND BACKGROUND: International guidelines recommend prioritized treatment initiation in hepatitis C virus (HCV)-infected patients with advanced liver disease. We aimed to evaluate whether the widespread usage of direct acting antivirals (DAAs) has led to a decrease in late presentation for care.STUDY: Data derived from the multicenter German Hepatitis C Cohort (GECCO) was analyzed. Treatment naive HCV-infected patients initiating DAA-based treatment between January 2014 and September 2017 were included. Advanced liver disease was defined by aspartate aminotransferase to platelet ratio index score ≥1.5, METAVIR≥F3, or FibroScan ≥9.5 kPa. Period prevalence and risk factors for late presentation were evaluated.RESULTS: Six hundred fifty-three HCV-monoinfected and 210 HIV/HCV-coinfected patients (mean age, 48.6±12.7 y; 65.5% male) were included. Overall 32.5% of patients had advanced liver disease. In 2014 39.4% of patients presented with advanced liver disease, decreasing to 30.1%, 34.4%, and 26.4% in the years 2015, 2016, and 2017 (P=0.057), respectively. Patients with and without advanced liver disease differed in age (P<0.0001), CD4 ≤350/µL (P=0.027), genotype (P=0.005), transmission route (P=0.047), body mass index (P<0.001), and time since diagnosis (P=0.007). In the multivariable binary logistic regression analysis GT3, age above 45 years and being diagnosed >2 years ago were positively and HCV transmission through men who have sex with men was negatively associated with advanced liver disease.CONCLUSIONS: Overall 32.5% of patients presented with advanced liver disease. We observed a trend toward a lower proportion of patients starting treatment late.GT3, age, years since HCV diagnosis and HCV transmission route were identified as risk factors for presentation with advanced liver disease.

AB - GOALS AND BACKGROUND: International guidelines recommend prioritized treatment initiation in hepatitis C virus (HCV)-infected patients with advanced liver disease. We aimed to evaluate whether the widespread usage of direct acting antivirals (DAAs) has led to a decrease in late presentation for care.STUDY: Data derived from the multicenter German Hepatitis C Cohort (GECCO) was analyzed. Treatment naive HCV-infected patients initiating DAA-based treatment between January 2014 and September 2017 were included. Advanced liver disease was defined by aspartate aminotransferase to platelet ratio index score ≥1.5, METAVIR≥F3, or FibroScan ≥9.5 kPa. Period prevalence and risk factors for late presentation were evaluated.RESULTS: Six hundred fifty-three HCV-monoinfected and 210 HIV/HCV-coinfected patients (mean age, 48.6±12.7 y; 65.5% male) were included. Overall 32.5% of patients had advanced liver disease. In 2014 39.4% of patients presented with advanced liver disease, decreasing to 30.1%, 34.4%, and 26.4% in the years 2015, 2016, and 2017 (P=0.057), respectively. Patients with and without advanced liver disease differed in age (P<0.0001), CD4 ≤350/µL (P=0.027), genotype (P=0.005), transmission route (P=0.047), body mass index (P<0.001), and time since diagnosis (P=0.007). In the multivariable binary logistic regression analysis GT3, age above 45 years and being diagnosed >2 years ago were positively and HCV transmission through men who have sex with men was negatively associated with advanced liver disease.CONCLUSIONS: Overall 32.5% of patients presented with advanced liver disease. We observed a trend toward a lower proportion of patients starting treatment late.GT3, age, years since HCV diagnosis and HCV transmission route were identified as risk factors for presentation with advanced liver disease.

U2 - 10.1097/MCG.0000000000001189

DO - 10.1097/MCG.0000000000001189

M3 - SCORING: Journal article

C2 - 30789853

VL - 54

SP - 192

EP - 199

JO - J CLIN GASTROENTEROL

JF - J CLIN GASTROENTEROL

SN - 0192-0790

IS - 2

ER -