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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Interferon | Research article

HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study

Authors: Curtis L. Cooper, Chrissi Galanakis, Jessy Donelle, Jeff Kwong, Rob Boyd, Lisa Boucher, Claire E. Kendall

Published in: BMC Infectious Diseases | Issue 1/2019

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Abstract

Background

Almost 1% of Canadians are hepatitis C (HCV)-infected. The liver-specific complications of HCV are established but the extra-hepatic comorbidity, multimorbidity, and its relationship with HCV treatment, is less well known. We describe the morbidity burden for people with HCV and the relationship between multimorbidity and HCV treatment uptake and cure in the pre- and post-direct acting antiviral (DAA) era.

Methods

We linked adults with HCV at The Ottawa Hospital Viral Hepatitis Program as of April 1, 2017 to provincial health administrative data and matched on age and sex to 5 Ottawa-area residents for comparison. We used validated algorithms to identify the prevalence of mental and physical health comorbidities, as well as multimorbidity (2+ comorbidities). We calculated direct age- and sex-standardized rates of comorbidity and comparisons were made by interferon-based and interferon-free, DAA HCV treatments.

Results

The mean age of the study population was 54.5 years (SD 11.4), 65% were male. Among those with HCV, 4% were HIV co-infected, 26% had liver cirrhosis, 47% received DAA treatment, and 57% were cured of HCV. After accounting for age and sex differences, the HCV group had greater multimorbidity (prevalence ratio (PR) 1.38, 95% confidence interval (CI) 1.20 to 1.58) and physical-mental health multimorbidity (PR 2.71, 95% CI 2.29–3.20) compared to the general population. Specifically, prevalence ratios for people with HCV were significantly higher for diabetes, renal failure, cancer, asthma, chronic obstructive pulmonary disease, substance use disorder, mood and anxiety disorders and liver failure. HCV treatment and cure were not associated with multimorbidity, but treatment prevalence was significantly lower among middle-aged individuals with substance use disorders despite no differences in prevalence of cure among those treated.

Conclusion

People with HCV have a higher prevalence of comorbidity and multimorbidity compared to the general population. While HCV treatment was not associated with multimorbidity, people with substance use disorder were less likely to be treated. Our results point to the need for integrated, comprehensive models of care delivery for people with HCV.
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Literature
1.
Rotermann M, Langlois K, Andonov A, Trubnikov M. Seroprevalence of hepatitis B and C virus infections: results from the 2007 to 2009 and 2009 to 2011 Canadian health measures survey. Health Rep. 2013;24(11):3–13.PubMed
2.
3.
Kwong JC, Ratnasingham S, Campitelli MA, et al. The impact of infection on population health: results of the Ontario burden of infectious diseases study. PLoS One. 2012;7(9):e44103.CrossRefPubMedPubMedCentral
4.
Myers RP, Krajden M, Bilodeau M, et al. Burden of disease and cost of chronic hepatitis C infection in Canada. Can J Gastroenterol Hepatol. 2014;28(5):243–50.CrossRefPubMedPubMedCentral
5.
Fabrizi F, Donato FM, Messa P. Association between hepatitis C virus and chronic kidney disease: a systematic review and meta-analysis. Ann Hepatol. 2018;17(3):364–91.CrossRefPubMed
6.
Henson JB, Sise ME. The association of hepatitis C infection with the onset of CKD and progression into ESRD. Semin Dial. 2019;32(2):108–18.CrossRefPubMed
7.
Kuna L, Jakab J, Smolic R, Wu GY, Smolic M. HCV extrahepatic manifestations. J Clin Transl Hepatol. 2019;7(2):172–82.PubMedPubMedCentral
8.
Park H, Chen C, Wang W, Henry L, Cook RL, Nelson DR. Chronic hepatitis C virus (HCV) increases the risk of chronic kidney disease (CKD) while effective HCV treatment decreases the incidence of CKD. Hepatology. 2018;67(2):492–504.CrossRefPubMed
9.
10.
Tsui JI, Vittinghoff E, Shlipak MG, et al. Association of hepatitis C seropositivity with increased risk for developing end-stage renal disease. Arch Intern Med. 2007;167(12):1271–6.CrossRefPubMed
11.
Adinolfi LE, Nevola R, Rinaldi L, Romano C, Giordano M. Chronic hepatitis C virus infection and depression. Clin Liver Dis. 2017;21(3):517–34.CrossRefPubMed
12.
Negro F, Esmat G. Extrahepatic manifestations in hepatitis C virus infection. J Adv Res. 2017;8(2):85–7.CrossRefPubMed
13.
Yeoh SW, Holmes ACN, Saling MM, Everall IP, Nicoll AJ. Depression, fatigue and neurocognitive deficits in chronic hepatitis C. Hepatol Int. 2018;12(4):294–304.CrossRefPubMed
14.
Adinolfi LE, Nevola R, Lus G, et al. Chronic hepatitis C virus infection and neurological and psychiatric disorders: an overview. World J Gastroenterol. 2015;21(8):2269–80.CrossRefPubMedPubMedCentral
15.
Pol S, Vallet-Pichard A, Hermine O. Extrahepatic cancers and chronic HCV infection. Nat Rev Gastroenterol Hepatol. 2018;15(5):283–90.CrossRefPubMed
16.
Masarone M, Persico M. Hepatitis C virus infection and non-hepatocellular malignancies in the DAA era: a systematic review and meta-analysis. Liver Int. 2019;39(7):1292–306.CrossRefPubMed
17.
Negro F. Facts and fictions of HCV and comorbidities: steatosis, diabetes mellitus, and cardiovascular diseases. J Hepatol. 2014;61(1 Suppl):S69–78.CrossRefPubMed
18.
Gastaldi G, Goossens N, Clement S, Negro F. Current level of evidence on causal association between hepatitis C virus and type 2 diabetes: a review. J Adv Res. 2017;8(2):149–59.CrossRefPubMed
19.
Fabiani S, Fallahi P, Ferrari SM, Miccoli M, Antonelli A. Hepatitis C virus infection and development of type 2 diabetes mellitus: systematic review and meta-analysis of the literature. Rev Endocr Metab Disord. 2018;19(4):405–20.CrossRefPubMed
20.
Negro F, Forton D, Craxi A, Sulkowski MS, Feld JJ, Manns MP. Extrahepatic morbidity and mortality of chronic hepatitis C. Gastroenterology. 2015;149(6):1345–60.CrossRefPubMed
21.
22.
Petta S, Macaluso FS, Craxi A. Cardiovascular diseases and HCV infection: a simple association or more? Gut. 2014;63(3):369–75.CrossRefPubMed
23.
Dore GJ, Altice F, Litwin AH, et al. Elbasvir-Grazoprevir to treat hepatitis C virus infection in persons receiving opioid agonist therapy: a randomized trial. Ann Intern Med. 2016;165(9):625–34.CrossRefPubMed
24.
Klein MB, Rollet KC, Saeed S, et al. HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality. HIV Med. 2013;14(1):10–20.CrossRefPubMed
25.
Stasi C, Silvestri C, Berni R, et al. Epidemiological, demographic and clinical data on chronic viral hepatitis C in Tuscany. Curr Med Res Opin. 2019;35(4):661–6.CrossRefPubMed
26.
Sicras-Mainar A, Navarro-Artieda R, Saez-Zafra M. Comorbidity, concomitant medication, use of resources and healthcare costs associated with chronic hepatitis C virus carriers in Spain. Gastroenterol Hepatol. 2018;41(4):234–44.CrossRefPubMed
27.
Lauffenburger JC, Mayer CL, Hawke RL, Brouwer KL, Fried MW, Farley JF. Medication use and medical comorbidity in patients with chronic hepatitis C from a US commercial claims database: high utilization of drugs with interaction potential. Eur J Gastroenterol Hepatol. 2014;26(10):1073–82.CrossRefPubMedPubMedCentral
28.
Liu CH, Yu ML, Peng CY, et al. Comorbidities, concomitant medications and potential drug-drug interactions with interferon-free direct-acting antiviral agents in hepatitis C patients in Taiwan. Aliment Pharmacol Ther. 2018;48(11–12):1290–300.CrossRefPubMed
29.
Ruzicka DJ, Tetsuka J, Fujimoto G, Kanto T. Comorbidities and co-medications in populations with and without chronic hepatitis C virus infection in Japan between 2015 and 2016. BMC Infect Dis. 2018;18(1):237.CrossRefPubMedPubMedCentral
30.
Louie KS, St Laurent S, Forssen UM, Mundy LM, Pimenta JM. The high comorbidity burden of the hepatitis C virus infected population in the United States. BMC Infect Dis. 2012;12:86.CrossRefPubMedPubMedCentral
31.
32.
Myers RP, Ramji A, Bilodeau M, Wong S, Feld JJ. An update on the management of hepatitis C: consensus guidelines from the Canadian association for the study of the liver. Can J Gastroenterol. 2012;26(6):359–75.CrossRefPubMedPubMedCentral
33.
Feld JJ, Jacobson IM, Hezode C, et al. Sofosbuvir and Velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection. N Engl J Med. 2015;373(27):2599–607.CrossRefPubMed
34.
Sulkowski M, Hezode C, Gerstoft J, et al. Efficacy and safety of 8 weeks versus 12 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin in patients with hepatitis C virus genotype 1 mono-infection and HIV/hepatitis C virus co-infection (C-WORTHY): a randomised, open-label phase 2 trial. Lancet. 2015;385(9973):1087–97.CrossRefPubMed
35.
Bourliere M, Gordon SC, Flamm SL, et al. Sofosbuvir, Velpatasvir, and Voxilaprevir for previously treated HCV infection. N Engl J Med. 2017;376(22):2134–46.CrossRefPubMed
36.
Poordad F, Felizarta F, Asatryan A, et al. Glecaprevir and pibrentasvir for 12 weeks for hepatitis C virus genotype 1 infection and prior direct-acting antiviral treatment. Hepatology. 2017;66(2):389–97.CrossRefPubMed
37.
Nagaty A, Abd El-Wahab EW. Real-life results of sofosbuvir based therapy in chronic hepatitis C -naive and -experienced patients in Egypt. PLoS One. 2017;12(10):e0184654.CrossRefPubMedPubMedCentral
38.
Miotto N, Mendes LC, Zanaga LP, et al. All-oral direct antiviral treatment for hepatitis C chronic infection in a real-life cohort: the role of cirrhosis and comorbidities in treatment response. PLoS One. 2018;13(7):e0199941.CrossRefPubMedPubMedCentral
39.
Austin PC, Daly PA, Tu JV. A multicenter study of the coding accuracy of hospital discharge administrative data for patients admitted to cardiac care units in Ontario. Am Heart J. 2002;144(2):290–6.CrossRefPubMed
40.
Gershon AS, Wang C, Guan J, Vasilevska-Ristovska J, Cicutto L, To T. Identifying patients with physician-diagnosed asthma in health administrative databases. Can Respir J. 2009;16(6):183–8.CrossRefPubMedPubMedCentral
41.
Schultz SE, Rothwell DM, Chen Z, Tu K. Identifying cases of congestive heart failure from administrative data: a validation study using primary care patient records. Chronic Dis Inj Can. 2013;33(3):160–6.PubMed
42.
Gershon AS, Wang C, Guan J, Vasilevska-Ristovska J, Cicutto L, To T. Identifying individuals with physcian diagnosed COPD in health administrative databases. COPD. 2009;6(5):388–94.CrossRefPubMed
43.
Jaakkimainen RL, Bronskill SE, Tierney MC, et al. Identification of physician-diagnosed Alzheimer's disease and related dementias in population-based administrative data: a validation study using family physicians' electronic medical records. J Alzheimers Dis. 2016;54(1):337–49.CrossRefPubMed
44.
Hux JE, Ivis F, Flintoft V, Bica A. Diabetes in Ontario: determination of prevalence and incidence using a validated administrative data algorithm. Diabetes Care. 2002;25(3):512–6.CrossRefPubMed
45.
Tu K, Campbell NR, Chen ZL, Cauch-Dudek KJ, McAlister FA. Accuracy of administrative databases in identifying patients with hypertension. Open Med. 2007;1(1):e18–26.PubMedPubMedCentral
46.
Antoniou T, Zagorski B, Loutfy MR, Strike C, Glazier RH. Validation of case-finding algorithms derived from administrative data for identifying adults living with human immunodeficiency virus infection. PLoS One. 2011;6(6):e21748.CrossRefPubMedPubMedCentral
47.
Widdifield J, Bernatsky S, Paterson JM, et al. Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care Res. 2013;65(10):1582–91.
48.
Mondor L, Maxwell CJ, Bronskill SE, Gruneir A, Wodchis WP. The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients. Qual Life Res. 2016;25(10):2619–32.CrossRefPubMed
49.
Thavorn K, Maxwell CJ, Gruneir A, et al. Effect of socio-demographic factors on the association between multimorbidity and healthcare costs: a population-based, retrospective cohort study. BMJ Open. 2017;7(10):e017264.CrossRefPubMedPubMedCentral
50.
Pefoyo AJ, Bronskill SE, Gruneir A, et al. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415.CrossRefPubMed
51.
Gruneir A, Bronskill SE, Maxwell CJ, et al. The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: a retrospective cohort study. BMC Health Serv Res. 2016;16:154.CrossRefPubMedPubMedCentral
52.
Lane NE, Maxwell CJ, Gruneir A, Bronskill SE, Wodchis WP. Absence of a socioeconomic gradient in older adults' survival with multiple chronic conditions. EBioMedicine. 2015;2(12):2094–100.CrossRefPubMedPubMedCentral
53.
Petrosyan Y, Bai YQ, Kone Pefoyo AJ, et al. The relationship between diabetes care quality and diabetes-related hospitalizations and the modifying role of comorbidity. Can J Diabetes. 2017;41(1):17–25.CrossRefPubMed
54.
Mondor L, Maxwell CJ, Hogan DB, et al. Multimorbidity and healthcare utilization among home care clients with dementia in Ontario, Canada: a retrospective analysis of a population-based cohort. PLoS Med. 2017;14(3):e1002249.CrossRefPubMedPubMedCentral
55.
Huntley AL, Johnson R, Purdy S, Valderas JM, Salisbury C. Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. Ann Fam Med. 2012;10(2):134–41.CrossRefPubMedPubMedCentral
56.
Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61(1 Suppl):S45–57.CrossRefPubMed
57.
Polaris Observatory HCVC. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2(3):161–76.CrossRef
58.
Breslow NE, Day NE. Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. IARC Sci Publ. 1987;82:1–406.
59.
Grebely J, Haire B, Taylor LE, et al. Excluding people who use drugs or alcohol from access to hepatitis C treatments - is this fair, given the available data? J Hepatol. 2015;63(4):779–82.CrossRefPubMedPubMedCentral
60.
WHO. Global hepatitis report 2017. Geneva: World Health Organization, 2017.
61.
Russo MW, Fried MW. Side effects of therapy for chronic hepatitis C. Gastroenterology. 2003;124(6):1711–9.CrossRefPubMed
62.
Shah H, Bilodeau M, Burak KW, et al. The management of chronic hepatitis C: 2018 guideline update from the Canadian association for the study of the liver. CMAJ. 2018;190(22):E677–E87.CrossRefPubMedPubMedCentral
63.
64.
Boucher LM, Bayoumi AM, Mark AE, et al. Hepatitis C testing, status and treatment among marginalized people who use drugs in an Inner city setting: an observational cohort study. Subst Use Misuse. 2019;54(1):18–30.CrossRefPubMed
65.
Marshall AD, Saeed S, Barrett L, et al. Restrictions for reimbursement of direct-acting antiviral treatment for hepatitis C virus infection in Canada: a descriptive study. CMAJ Open. 2016;4(4):E605–E14.CrossRefPubMedPubMedCentral
66.
Martin NK, Vickerman P, Grebely J, et al. Hepatitis C virus treatment for prevention among people who inject drugs: modeling treatment scale-up in the age of direct-acting antivirals. Hepatology. 2013;58(5):1598–609.CrossRefPubMed
67.
Backus LI, Boothroyd DB, Phillips BR, Belperio P, Halloran J, Mole LA. A sustained virologic response reduces risk of all-cause mortality in patients with hepatitis C. Clin Gastroenterol Hepatol. 2011;9(6):509–16 e1.CrossRefPubMed
68.
Cacoub P, Bondin M, Hayes O, Pinsky B, Negro F. Quality of life in patients with psychiatric disorders: pooled analysis from Glecaprevir/Pibrentasvir Registrational studies. (abstract #150). In: The liver meeting. San Francisco: AASLD; 2018.
69.
Hsu YC, Ho HJ, Huang YT, et al. Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection. Gut. 2015;64(3):495–503.CrossRefPubMed
70.
Janjua N, Wong S, Rossi C, et al. The impact of HCV sustained virologic response from direct acting antiviral and interferon-based treatments on mortality in a large population based cohort study (abstract #145). In: The liver meeting. San Francisco: AASLD; 2018.
71.
Park H, Wang W, Henry L, Nelson D. Impact of all-Oral direct-acting antivirals on clinical and economic outcomes in chronic hepatitis C virus-infected patients in the U.S. (abstract #146). In: The liver meeting. San Francisco: AASLD; 2018.
72.
Rossi C, Butt Z, Chapinal N, et al. Sustained virologic responses reduces the incidence of extrahepatic manifestations in chronic hepatitis C infection. (abstract #148). In: The liver meeting. San Francisco: AASLD; 2018.
73.
van der Meer AJ, Veldt BJ, Feld JJ, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA. 2012;308(24):2584–93.CrossRefPubMed
74.
Dahrouge S, Devlin R, Hogg B, Russell G, Coyle D, Fergusson D. The economic impact of improvements in primary healthcare performance. Ottawa, ON: Canadian Health Services Research Foundation. 2012.
75.
Rothman AA, Wagner EH. Chronic illness management: what is the role of primary care? Ann Intern Med. 2003;138(3):256–61.CrossRefPubMed
76.
Mitruka K, Thornton K, Cusick S, et al. Expanding primary care capacity to treat hepatitis C virus infection through an evidence-based care model--Arizona and Utah, 2012-2014. MMWR Morb Mortal Wkly Rep. 2014;63(18):393–8.PubMedPubMedCentral
77.
Groessl EJ, Weingart KR, Gifford AL, Asch SM, Ho SB. Development of the hepatitis C self-management program. Patient Educ Couns. 2011;83(2):252–5.CrossRefPubMed
78.
Gonzalez SA, Fierer DS, Talal AH. Medical and behavioral approaches to engage people who inject drugs into Care for Hepatitis C Virus Infection. Addict Disord Their Treat. 2017;16(2 Suppl 1):S1–S23.CrossRefPubMedPubMedCentral
79.
Meyer JP, Moghimi Y, Marcus R, Lim JK, Litwin AH, Altice FL. Evidence-based interventions to enhance assessment, treatment, and adherence in the chronic hepatitis C care continuum. Int J Drug Policy. 2015;26(10):922–35.CrossRefPubMedPubMedCentral
80.
Talal AH, Thomas DL, Reynolds JL, Khalsa JH. Toward optimal control of hepatitis C virus infection in persons with substance use disorders. Ann Intern Med. 2017;166(12):897–8.CrossRefPubMed
Metadata
Title
HCV-infected individuals have higher prevalence of comorbidity and multimorbidity: a retrospective cohort study
Authors
Curtis L. Cooper
Chrissi Galanakis
Jessy Donelle
Jeff Kwong
Rob Boyd
Lisa Boucher
Claire E. Kendall
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Interferon
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-4315-6

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Keynote webinar | Spotlight on medication adherence

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Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

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