Data presented during the Digestive Disease Week 2012 Annual Meeting
suggest that a significant number of patients with hepatitis C virus are
expected to progress to advanced liver disease annually.
“This alarming finding places additional stress on an already
overburdened health care system, which will need to prepare for an increase in
patients suffering from advanced liver disease,” Ann Kwong, PhD, vice
president and HCV franchise lead at Vertex Pharmaceuticals, said in a press
release. “It is critical to treat HCV patients before they develop costly
and irreversible liver complications.”
Kwong and colleagues at Trinity Partners analyzed data from Medicare and
commercial insurance claims databases to determine the rate of progression to
advanced liver disease. They identified the number of patients with HCV with
and without advanced liver disease using ICD-9 codes and to project future
advanced liver disease prevalence via progression and mortality rate trends.
More than 1 million patients with HCV were divided into four age groups:
16 to 44 years; 45 to 54 years; 55 to 64 years; 65 years and older. The
researchers found that proportion of patients with advanced liver disease
increased with age: 9.1% in those aged 16 to 44 years; 17% in those aged 45 to
54 years; and 22.2% in those aged 55 to 65 years. However, only 18.8% of those
aged at least 65 years had advanced liver disease, as all-cause mortality
outpaced advanced liver disease progression.
to view larger table.
Further, in the baby-boomer cohort (45 to 64 years age group) 4.4% of
patients diagnosed with chronic HCV progressed to advanced liver disease
annually; 11.5% of those with cirrhosis progressed to decompensated cirrhosis;
and 3.2% of those with cirrhosis and 4.2% of those with decompensated cirrhosis
progressed to liver cancer and/or transplant.
“Without treatment, the number of patients already diagnosed with
HCV progressing to advanced liver disease is expected to increase from 195,000
in 2008 to 303,000 in 2015,” the researchers concluded. Also,
approximately 298,000 undiagnosed patients are estimated to progress to
advanced liver disease from 2008 to 2015.
In total, without diagnosis and treatment, approximately 601,000 people
with chronic HCV, the majority of whom are baby boomers, are projected to
progress to advanced liver disease by 2015. These data support the recent CDC
proposal to perform age-based screening targeting baby boomers as a potential
strategy to decrease progression to advanced liver disease.
Zalesak M. #SA1084. Presented at: Digestive Disease Week 2012 Annual
Meeting; May 29-22: San Diego.
This study was funded by Vertex Pharmaceuticals.