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• W2914552015 abstract "Introduction: The approval of all oral direct acting antiviral agents (DAA) for hepatitis C (HCV) has revolutionized the treatment of chronic HCV. There are limited data on treatment initiation and drug utilization in the US; that is, how many HCV-infected individuals who are eligible for DAAs initiate therapy. The AIMS were to evaluate rates of treatment initiation in patients with HCV infection treated in the initial period of all-oral DAA, time to DAA treatment, and predictors of initiating DAA treatment. Methods: This was a retrospective cohort analysis using EMR/chart review of HCV infected patients over 18 years of age with a documented ICD-9 and/or ICD-10 code of non-acute HCV during the period of January 1, 2014, to December 31, 2015 identified in the Indiana University Health data warehouse. Baseline characteristics included age, gender, type of insurance, HCV treatment regimen, Charlson Comorbidity Index, history of drug use, and concomitant medicines including acid-reducing medications. Prior HCV treatment history, genotype, fibrosis level were also captured. Those individuals with at least one record of an all oral DAA prescription filled during the study period were included in the DAA Treated cohort. Patients with chronic HCV infection without oral DAA treatment were included in the HCV Untreated cohort. Results: 8,407 chronic HCV patients were included, of which 830 patients initiated DAA therapy, while 7,539 patients did not initiate DAA therapy during follow-up for up to two years. The estimated incidence of treatment from Kaplan-Meier was 8.80% ± 0.34%; at year one and was 15 ± 0.5% at year two, respectively. The median time to initiating therapy was 300 days. Using a logistic regression analysis, positive predictors of initiation of DAA treatment included age, prior HCV treatment (HR = 1.74), cirrhosis (HR= 2.64), and a history of liver transplant (HR=1.50). History of drug abuse (HR = 0.44), Medicaid (HR = 0.64) and self-pay (HR = 0.39) were negatively associated to initiation of therapy. Conclusion: In the initial era of all-oral DAA therapy, 9.9% of the HCV cohort was treated. Advanced fibrosis, prior therapy, age, and a history of liver transplant predicted initiation of therapy. Future analyses may evaluate the time to DAA treatment initiation among those with less severe disease." @default.
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• W2914552015 date "2017-10-01" @default.
• W2914552015 modified "2023-09-26" @default.
• W2914552015 title "Initial Uptake and Time to Treatment of all Oral Direct Acting Antivirals for Hepatitis C" @default.
• W2914552015 doi "https://doi.org/10.14309/00000434-201710001-00894" @default.
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