Wei Wang1, Vincent Lo Re2, Yi Guo3, Hong Xiao1, Joshua Brown1, Haesuk Park1. 1. Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA. 2. Division of Infectious Diseases, Department of Medicine and Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. College of Medicine, University of Florida, Gainesville, FL, USA.
Abstract
BACKGROUND: Hepatitis C virus (HCV) infection is associated with with an increased risk of non-hepatic cancers, but the impact of HCV treatment on non-hepatic cancer is unclear. AIMS: To assess if HCV treatment reduced the incidence of non-hepatic cancers among patients with chronic HCV infection in the US. METHODS: We conducted a retrospective cohort study in MarketScan Databases from January 2005 to December 2016. Multivariable, time-varying Cox proportional-hazards models were used to determine hazard ratios (HRs) of incident non-hepatic cancers in treated and untreated patients with HCV infection. We conduscted subgroup analyses for sex, age, and presence of cirrhosis or diabetes. RESULTS: Among 62 078 patients with newly diagnosed HCV infection, 17 302 (28%) initiated HCV treatment, among whom 15 322 completed 8-16 weeks treatment (minimally effective treatment). Patients who initiated HCV treatment had an 11% decreased risk of developing an incident non-hepatic cancer compared to untreated patients (HR = 0.89, 95% confidence interval (Cl) = 0.82-0.96). The reduction was slightly higher when patients completed a minimally effective treatment (HR = 0.87; 95% Cl = 0.80 - 0.95). This was observed in most subgroup analyses for those who had a minimally effective treatment including patients with cirrhosis. When we stratified cancer or therapy subtypes, the association remained consistent for pancreatic and lung cancers, and dual HCV therapy. CONCLUSIONS: HCV treatment led to a significantly reduced incidence of non-hepatic cancers among patients with HCV infection. Despite discrepancies between cancer or HCV therapy subtypes, our findings suggest that treating HCV infection can decrease the extrahepatic cancer burden associated with chronic HCV infection.
BACKGROUND:Hepatitis C virus (HCV) infection is associated with with an increased risk of non-hepatic cancers, but the impact of HCV treatment on non-hepatic cancer is unclear. AIMS: To assess if HCV treatment reduced the incidence of non-hepatic cancers among patients with chronic HCV infection in the US. METHODS: We conducted a retrospective cohort study in MarketScan Databases from January 2005 to December 2016. Multivariable, time-varying Cox proportional-hazards models were used to determine hazard ratios (HRs) of incident non-hepatic cancers in treated and untreated patients with HCV infection. We conduscted subgroup analyses for sex, age, and presence of cirrhosis or diabetes. RESULTS: Among 62 078 patients with newly diagnosed HCV infection, 17 302 (28%) initiated HCV treatment, among whom 15 322 completed 8-16 weeks treatment (minimally effective treatment). Patients who initiated HCV treatment had an 11% decreased risk of developing an incident non-hepatic cancer compared to untreated patients (HR = 0.89, 95% confidence interval (Cl) = 0.82-0.96). The reduction was slightly higher when patients completed a minimally effective treatment (HR = 0.87; 95% Cl = 0.80 - 0.95). This was observed in most subgroup analyses for those who had a minimally effective treatment including patients with cirrhosis. When we stratified cancer or therapy subtypes, the association remained consistent for pancreatic and lung cancers, and dual HCV therapy. CONCLUSIONS:HCV treatment led to a significantly reduced incidence of non-hepatic cancers among patients with HCV infection. Despite discrepancies between cancer or HCV therapy subtypes, our findings suggest that treating HCV infection can decrease the extrahepatic cancer burden associated with chronic HCV infection.
Authors: Francesco Negro; Daniel Forton; Antonio Craxì; Mark S Sulkowski; Jordan J Feld; Michael P Manns Journal: Gastroenterology Date: 2015-08-28 Impact factor: 22.682
Authors: Robert D Allison; Xin Tong; Anne C Moorman; Kathleen N Ly; Loralee Rupp; Fujie Xu; Stuart C Gordon; Scott D Holmberg Journal: J Hepatol Date: 2015-05-01 Impact factor: 25.083
Authors: Darrick K Li; Yanjie Ren; Daniel S Fierer; Stephanie Rutledge; Obaid S Shaikh; Vincent Lo Re; Tracey Simon; Abdul-Badi Abou-Samra; Raymond T Chung; Adeel A Butt Journal: Hepatology Date: 2018-04-19 Impact factor: 17.425
Authors: Maxine M Denniston; Ruth B Jiles; Jan Drobeniuc; R Monina Klevens; John W Ward; Geraldine M McQuillan; Scott D Holmberg Journal: Ann Intern Med Date: 2014-03-04 Impact factor: 25.391
Authors: Edward J Gane; Catherine A Stedman; Robert H Hyland; Xiao Ding; Evguenia Svarovskaia; William T Symonds; Robert G Hindes; M Michelle Berrey Journal: N Engl J Med Date: 2013-01-03 Impact factor: 91.245
Authors: Xinyi Jiang; Scott Martin Vouri; Vakaramoko Diaby; Weihsuan Lo-Ciganic; Robert Parker; Haesuk Park Journal: J Manag Care Spec Pharm Date: 2021-10
Authors: Walaa E Kattan; Junchen Liu; Dina Montufar-Solis; Hong Liang; Bhargavi Brahmendra Barathi; Ransome van der Hoeven; Yong Zhou; John F Hancock Journal: Proc Natl Acad Sci U S A Date: 2021-12-21 Impact factor: 12.779
Authors: Xinyi Jiang; Robert L Parker; Scott Martin Vouri; Weihsuan Lo-Ciganic; Vakaramoko Diaby; Linda Henry; Haesuk Park Journal: Am J Prev Med Date: 2021-06-29 Impact factor: 6.604