Sylvie Deuffic-Burban1, Philippe Mathurin2, Isabelle Rosa3, Anne-Marie Bouvier4, Amélie Cannesson5, Abbas Mourad1, Valérie Canva5, Alexandre Louvet2, Pierre Deltenre6, Emmanuel Boleslawski7, Stéphanie Truant7, François-René Pruvot7, Sébastien Dharancy8. 1. Inserm U995, University of Lille Nord de France, Lille, France; Inserm ATIP-AVENIR, Denis Diderot University, Paris, France. 2. Inserm U995, University of Lille Nord de France, Lille, France; Hepatology Unit, Claude Huriez Hospital, CHRU Lille, Lille, France. 3. Intercommunal Hospital, Créteil, France. 4. Inserm U866/Digestive Cancer Registry, Faculty of Medicine, Dijon, France; University Hospital, Burgundy University, Dijon, France. 5. Hepatology Unit, Claude Huriez Hospital, CHRU Lille, Lille, France. 6. Hepatology Unit, Claude Huriez Hospital, CHRU Lille, Lille, France; Hepato-Gastroenterology Unit, Jolimont Hospital, Haine-Saint-Paul, Belgium. 7. Digestive Surgery and Liver Transplantation Unit, Claude Huriez Hospital, CHRU Lille, Lille, France. 8. Inserm U995, University of Lille Nord de France, Lille, France; Hepatology Unit, Claude Huriez Hospital, CHRU Lille, Lille, France. Electronic address: sebastien.dharancy@chru-lille.fr.
Abstract
BACKGROUND: In light of the impact of emerging hepatitis C virus treatments on morbidity and mortality, we sought to determine whether candidates for liver transplantation for hepatocellular carcinoma and decompensated cirrhosis will decrease sufficiently to match liver grafts for hepatitis C virus-infected patients. AIMS: Using a Markov model, we quantified future liver graft needs for hepatitis C virus-induced diseases and estimated the impact of current and emerging treatments. METHODS: We simulated progression of yearly-hepatitis-C-virus-infected cohorts from the beginning of the epidemic and calculated 2013-2022 candidates for liver transplantation up until 2022 without and with therapies. We compared these estimated numbers to projected trends in liver grafts for hepatitis C virus. RESULTS: Overall, current treatment would avoid transplantation of 4425 (4183-4684) potential candidates during the period 2013-2022. It would enable an 88% and 42% reduction in the gap between liver transplantation activity and candidates for hepatocellular carcinoma and decompensated cirrhosis, respectively. Emerging hepatitis C virus treatments would allow adequacy in transplant activities for hepatocellular carcinoma. However, they would not lead to adequacy in decompensated cirrhosis from 2013 to 2022. Results were robust to sensitivity analysis. CONCLUSION: Our study indicates that patients will benefit from public health policies regarding hepatitis C virus screening and therapeutic access to new emerging treatments.
BACKGROUND: In light of the impact of emerging hepatitis C virus treatments on morbidity and mortality, we sought to determine whether candidates for liver transplantation for hepatocellular carcinoma and decompensated cirrhosis will decrease sufficiently to match liver grafts for hepatitis C virus-infectedpatients. AIMS: Using a Markov model, we quantified future liver graft needs for hepatitis C virus-induced diseases and estimated the impact of current and emerging treatments. METHODS: We simulated progression of yearly-hepatitis-C-virus-infected cohorts from the beginning of the epidemic and calculated 2013-2022 candidates for liver transplantation up until 2022 without and with therapies. We compared these estimated numbers to projected trends in liver grafts for hepatitis C virus. RESULTS: Overall, current treatment would avoid transplantation of 4425 (4183-4684) potential candidates during the period 2013-2022. It would enable an 88% and 42% reduction in the gap between liver transplantation activity and candidates for hepatocellular carcinoma and decompensated cirrhosis, respectively. Emerging hepatitis C virus treatments would allow adequacy in transplant activities for hepatocellular carcinoma. However, they would not lead to adequacy in decompensated cirrhosis from 2013 to 2022. Results were robust to sensitivity analysis. CONCLUSION: Our study indicates that patients will benefit from public health policies regarding hepatitis C virus screening and therapeutic access to new emerging treatments.
Authors: Francesca Romana Ponziani; Francesca Mangiola; Cecilia Binda; Maria Assunta Zocco; Massimo Siciliano; Antonio Grieco; Gian Lodovico Rapaccini; Maurizio Pompili; Antonio Gasbarrini Journal: World J Hepatol Date: 2017-03-08
Authors: Daniel J Felmlee; Audrey Coilly; Raymond T Chung; Didier Samuel; Thomas F Baumert Journal: Lancet Infect Dis Date: 2016-06 Impact factor: 71.421