BACKGROUND: A key question in care of patients with chronic hepatitis C virus (HCV) infection is beginning treatment immediately vs delaying treatment. Risks of mortality and disease progression in "real world" settings are important to assess the implications of delaying HCV treatment. METHODS: This was a cohort study of HCV patients identified from 4 integrated health systems in the United States who had liver biopsies during 2001-2012. The probabilities of death and progression to hepatocellular carcinoma, hepatic decompensation (hepatic encephalopathy, esophageal varices, ascites, or portal hypertension) or liver transplant were estimated over 1, 2, or 5 years by fibrosis stage (Metavir F0-F4) determined by biopsy at beginning of observation. RESULTS: Among 2799 HCV-monoinfected patients who had a qualifying liver biopsy, the mean age at the time of biopsy was 50.7 years. The majority were male (58.9%) and non-Hispanic white (66.9%). Over a mean observation of 5.0 years, 261 (9.3%) patients died and 34 (1.2%) received liver transplants. At 5 years after biopsy, the estimated risk of progression to hepatic decompensation or hepatocellular carcinoma was 37.2% in stage F4, 19.6% in F3, 4.7% in F2, and 2.3% in F0-F1 patients. Baseline biopsy stage F3 or F4 and platelet count below normal were the strongest predictors of progression to hepatic decompensation or hepatocellular carcinoma. CONCLUSIONS: The risks of death and progression to liver failure varied greatly by fibrosis stage. Clinicians and policy makers could use these progression risk data in prioritization and in determining the timing of treatment for patients in early stages of liver disease. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
BACKGROUND: A key question in care of patients with chronic hepatitis C virus (HCV) infection is beginning treatment immediately vs delaying treatment. Risks of mortality and disease progression in "real world" settings are important to assess the implications of delaying HCV treatment. METHODS: This was a cohort study of HCVpatients identified from 4 integrated health systems in the United States who had liver biopsies during 2001-2012. The probabilities of death and progression to hepatocellular carcinoma, hepatic decompensation (hepatic encephalopathy, esophageal varices, ascites, or portal hypertension) or liver transplant were estimated over 1, 2, or 5 years by fibrosis stage (Metavir F0-F4) determined by biopsy at beginning of observation. RESULTS: Among 2799 HCV-monoinfected patients who had a qualifying liver biopsy, the mean age at the time of biopsy was 50.7 years. The majority were male (58.9%) and non-Hispanic white (66.9%). Over a mean observation of 5.0 years, 261 (9.3%) patients died and 34 (1.2%) received liver transplants. At 5 years after biopsy, the estimated risk of progression to hepatic decompensation or hepatocellular carcinoma was 37.2% in stage F4, 19.6% in F3, 4.7% in F2, and 2.3% in F0-F1 patients. Baseline biopsy stage F3 or F4 and platelet count below normal were the strongest predictors of progression to hepatic decompensation or hepatocellular carcinoma. CONCLUSIONS: The risks of death and progression to liver failure varied greatly by fibrosis stage. Clinicians and policy makers could use these progression risk data in prioritization and in determining the timing of treatment for patients in early stages of liver disease. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Authors: Dana J T Bruden; Brian J McMahon; Lisa Townshend-Bulson; Prabhu Gounder; Jim Gove; Julia Plotnik; Chriss Homan; Annette Hewitt; Youssef Barbour; Philip R Spradling; Brenna C Simons; Susan McArdle; Michael Bruce Journal: Hepatology Date: 2017-05-22 Impact factor: 17.425
Authors: Andrew J Leidner; Harrell W Chesson; Philip R Spradling; Scott D Holmberg Journal: Appl Health Econ Health Policy Date: 2017-02 Impact factor: 2.561
Authors: Joseph A Boscarino; Anne C Moorman; Loralee B Rupp; Yueren Zhou; Mei Lu; Eyasu H Teshale; Stuart C Gordon; Philip R Spradling; Mark A Schmidt; Connie Mah Trinacty; Yuna Zhong; Scott D Holmberg; Deborah Holtzman Journal: Dig Dis Sci Date: 2017-09-06 Impact factor: 3.199
Authors: Marcus-Alexander Wörns; Peter Robert Galle; Stefan Zeuzem; Peter Schirmacher; Michael Manns; Arndt Vogel Journal: Dtsch Arztebl Int Date: 2017-09-04 Impact factor: 5.594
Authors: Ingmar Mederacke; Aveline Filliol; Silvia Affo; Ajay Nair; Celine Hernandez; Qiuyan Sun; Florian Hamberger; Francesco Brundu; Yu Chen; Aashreya Ravichandra; Peter Huebener; Helena Anke; Hongxue Shi; Raquel A Martínez García de la Torre; James R Smith; Neil C Henderson; Florian W R Vondran; Carla V Rothlin; Heike Baehre; Ira Tabas; Pau Sancho-Bru; Robert F Schwabe Journal: Sci Transl Med Date: 2022-04-06 Impact factor: 19.319
Authors: Anne C Moorman; Loralee B Rupp; Stuart C Gordon; Yuna Zhong; Jian Xing; Mei Lu; Joseph A Boscarino; Mark A Schmidt; Yihe G Daida; Eyasu H Teshale; Philip R Spradling; Scott D Holmberg Journal: Infect Dis Clin North Am Date: 2018-06 Impact factor: 5.982
Authors: Luzelena Caro; Larissa Wenning; Zifang Guo; Iain P Fraser; Christine Fandozzi; Jennifer Talaty; Deborah Panebianco; Maureen Ho; Naoto Uemura; Christina Reitmann; Peter Angus; Edward Gane; Thomas Marbury; William B Smith; Marian Iwamoto; Joan R Butterton; Wendy W Yeh Journal: Antimicrob Agents Chemother Date: 2017-11-22 Impact factor: 5.938