Analysis aims to stratify progression among infected

Banff, Canada—In chronic hepatitis C infection, longer duration of infection and genotype 1 infection are independently associated with slower progression of disease, according to researchers in Canada.

Their meta-analysis—an update of the group’s 2008 study—also revealed that male sex and blood transfusion are associated with faster progression.

“We need better estimates of disease progression in hepatitis C–infected individuals,” said Aysegul Erman, MS, a doctoral candidate at the University of Toronto, who helped conduct the study. “Studies such as this could offer patients a better understanding of how fast they will progress in their disease.”

Accurate estimation of the progression of HCV disease plays a key role in evaluating the cost-effectiveness of treatment and determining treatment prioritization, Ms. Erman added.

Longer duration of infection and genotype 1 infection were independently associated with slower disease progression. Being male and receiving a blood transfusion were associated with faster progression. Compared with liver clinic patients, children and injection drug users experienced more rapid progression. The estimated unadjusted time to cirrhosis was 37 years for the total population. By subgroup, the estimated time was 36 years for patients identified in a clinical setting, 48 for those in nonclinical settings, 59 for genotype 1 and 30 for genotype 3, according to the researchers.

The findings may help physicians to predict their patients’ disease progression and give them more clarity into their prognosis, Ms. Erman said. “This could be useful for physicians and patients to understand at what rate they’ll progress to cirrhosis or to another clinically relevant stage of disease … which could indicate if you should start treatment or not,” she said. These estimates also may allow for more accurate estimation of the cost-effectiveness of new HCV antiviral agents, as well as alternative prevention strategies targeting different groups of patients.

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