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Predicted effects of HCV treatment vary among European countries

The most recent issue of Gastroenterology investigates the predicted effects of treatment for HCV infection among European countries.

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The dynamics of hepatitis C virus (HCV) infection, as well as screening practices and access to therapy, vary among European countries.

Dr Philippe Mathurin and colleagues from France determined the magnitude of the effects of such differences on incidence and mortality of infection.

The researchers compared the dynamics of infection and screening and treatment practices among Belgium, France, Germany, Italy, Spain, and the United Kingdom.

The team also assessed the effects of treatment with pegylated interferon and additional effects of triple therapy with protease inhibitors.

Antiviral treatment of patients with HCV genotype 1 will reduce mortality by 10% overall
Gastroenterology

The research team created a country-specific Markov model of HCV progression based on published epidemiologic data, and reports of competitive and hepatocellular carcinoma mortality for the 6 countries.

The model was used to predict the incidence of HCV-related cirrhosis and its mortality until 2021 for each country.

From 2002 to 2011, antiviral therapy reduced the cumulative incidence of cirrhosis by 7% and deaths by 3% overall.

The team observed that reductions in incidence and mortality values ranged from 4% and 2%, respectively, in Italy to 16% and 9%, respectively, in France.

From 2012 to 2021, antiviral treatment of patients with HCV genotype 1 infection that includes protease inhibitor–based triple therapy will reduce the cumulative incidence of cirrhosis by 18%, and mortality by 10% overall.

The team found that the smallest reduction is predicted for Italy, and the highest is for France.

Dr Mathurin's team commented, "Although HCV infection is treated with the same therapies in different countries, the effects of the therapies on morbidity and mortality vary significantly."

"In addition to common guidelines that are based on virologic response-guided therapy, there is a need for public health policies based on population-guided therapy."

Gastroenterology 2012: 143(4): 974-985.e14
09 October 2012

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