Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK

Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient...

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Main Authors: Hudson, Benjamin, Walker, Alex J., Irving, William L.
Format: Article
Published: Wiley 2017
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Online Access:https://eprints.nottingham.ac.uk/42084/
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author Hudson, Benjamin
Walker, Alex J.
Irving, William L.
author_facet Hudson, Benjamin
Walker, Alex J.
Irving, William L.
author_sort Hudson, Benjamin
building Nottingham Research Data Repository
collection Online Access
description Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012–October 2014 the characteristics of the CHC population currently under specialist care in the UK were evaluated – with specific focus upon use of medications, adverse lifestyle choices, and comorbidities.. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analysed by history of injecting drug use (IDU), age, and severity of liver disease. 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non-IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non-IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose in the DAA era.
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spelling nottingham-420842020-05-04T19:02:47Z https://eprints.nottingham.ac.uk/42084/ Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK Hudson, Benjamin Walker, Alex J. Irving, William L. Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012–October 2014 the characteristics of the CHC population currently under specialist care in the UK were evaluated – with specific focus upon use of medications, adverse lifestyle choices, and comorbidities.. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analysed by history of injecting drug use (IDU), age, and severity of liver disease. 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non-IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non-IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose in the DAA era. Wiley 2017-08-30 Article PeerReviewed Hudson, Benjamin, Walker, Alex J. and Irving, William L. (2017) Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK. Journal of Medical Virology, 89 (12). pp. 2158-2164. ISSN 1096-9071 Chronic hepatitis C Direct-acting antivirals Drug–drug interaction Hepatitis C virus Injecting drug use http://onlinelibrary.wiley.com/doi/10.1002/jmv.24848/abstract doi:10.1002/jmv.24848 doi:10.1002/jmv.24848
spellingShingle Chronic hepatitis C
Direct-acting antivirals
Drug–drug interaction
Hepatitis C virus
Injecting drug use
Hudson, Benjamin
Walker, Alex J.
Irving, William L.
Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title_full Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title_fullStr Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title_full_unstemmed Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title_short Comorbities and medications of patients with chronic hepatitis C under specialist care in the UK
title_sort comorbities and medications of patients with chronic hepatitis c under specialist care in the uk
topic Chronic hepatitis C
Direct-acting antivirals
Drug–drug interaction
Hepatitis C virus
Injecting drug use
url https://eprints.nottingham.ac.uk/42084/
https://eprints.nottingham.ac.uk/42084/
https://eprints.nottingham.ac.uk/42084/