Hepatitis C treatment outcomes in Australian clinics

Heather F. Gidding, Matthew G. Law, Janaki Amin, George Ostapowicz, Martin Weltman, Graeme A. Macdonald, Joe J. Sasadeusz, Paul A. W. Haber, Jacob George, Gregory J. Dore

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22 Citations (Scopus)

Abstract

Objective: To determine hepatitis C (HCV) treatment effectiveness and predictors of response in the "real-world" Australian clinic setting. Design, setting and participants: Patients with chronic HCV, who were HCVtreatment- naive at enrolment, and were then treated with standard therapy (pegylated interferon-α plus ribavirin), were recruited prospectively through a national network of 24 HCV clinics between April 2008 and December 2009. Patients were interviewed and a medical record review was conducted at enrolment and at routine follow-up clinic visits. Main outcome measures: Proportion of patients achieving a sustained virological response (SVR), predictors of SVR, and impact of treatment on biochemical markers of liver disease (alanine aminotransferase levels and aspartate aminotransferase-to-platelet ratio index scores). Results: The SVR by intention to treat was 60% (327/550). Infection with HCV genotype 2 or 3 (compared with genotype 1) was an independent predictor of SVR (odds ratio [OR], 2.45; 95% CI, 1.70-3.52), while HIV coinfection (OR, 0.28; 95% CI, 0.10-0.82), cirrhosis (OR, 0.38; 95% CI, 0.18-0.81), and increased body mass index for ≥ 30 kg/m2 v ≤25 kg/m2 (OR, 0.58; 95% CI, 0.35-0.96) were independently associated with lower SVR. There was a significant improvement in biochemical markers of liver disease following SVR (P <0.001). Conclusions: Our findings are similar to those seen in clinical trials, despite the inclusion of patients with a broad range of comorbid conditions such as injecting drug and alcohol use and psychiatric illness. They suggest that, with appropriate patient and infrastructure support, expansion of treatment services to the broader HCV-infected community is warranted.

Original languageEnglish
Pages (from-to)633-637
Number of pages5
JournalMedical Journal of Australia
Volume196
Issue number10
DOIs
Publication statusPublished - Jun 2012
Externally publishedYes

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    Gidding, H. F., Law, M. G., Amin, J., Ostapowicz, G., Weltman, M., Macdonald, G. A., ... Dore, G. J. (2012). Hepatitis C treatment outcomes in Australian clinics. Medical Journal of Australia, 196(10), 633-637. https://doi.org/10.5694/mja12.10014