Sunday, June 10, 2018

USA HCV Dataset - Patients’ age, location, disease severity, treatment and cure status 2013-2016

Advances in Therapy
Development of a Comprehensive Dataset of Hepatitis C Patients and Examination of Disease Epidemiology in the United States, 2013–2016
Viktor V. Chirikov Steven E. Marx Shivaji R. Manthena John P. Strezewski Sammy Saab

First Online: 09 June 2018
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Hepatitis C virus (HCV) infection may cause serious health problems and death. Unfortunately, the health care community does not have complete identification of patients with HCV. This study describes the creation of a dataset that combines information for HCV patients and shows relevant information about HCV patients’ age, geographic location, disease severity, and treatment and cure status from 2013 through 2016. This dataset helps the health care community understand the HCV patient landscape and make informed decisions about how to best treat this population.

Chronic infection with hepatitis C virus (HCV) is a leading cause of liver disease and infectious disease deaths. While recent and emerging treatment options for HCV patients have enabled higher rates of sustained virologic response (SVR), the demographic, clinical, geographic, and payer characteristics of the estimated 3.4 million chronic HCV patients in the USA are poorly understood. The goal of this study was to create a dataset describing the current HCV patient landscape in the USA.

Data from two large national laboratory companies representing the majority of US patients screened for HCV antibody and/or tested for HCV RNA from 2013 through 2016 were organized into the present study dataset. Age, gender, payer channel, 3-digit ZIP code and ordering physician specialty, and 3-digit ZIP code information were available for all patients. Among RNA-positive patients, additional clinical characteristics included HCV genotype, fibrosis stage, renal function, and HIV status. Initiating treatment and attaining cure were imputed using data-driven algorithms based on successive RNA viral load measurements.

The number of RNA-positive HCV patients increased from 200,066 patients in 2013 to 469,550 in 2016. The availability of clinical data measurements and rates of treatment initiation increased over the study period, indicating improved care engagement for HCV patients. Treatment and cure rates varied by age, disease severity, geographic location, and payer channel. Sensitivity and specificity of the cure prediction algorithms were consistently above 0.90, validating the robustness of the data imputation approach.

This is the largest, most comprehensive dataset available to describe the current US HCV patient landscape. Our results highlight that the epidemiology of HCV is evolving with an increasing number of patients who are younger and have milder disease than described in previous years. Results of this study should help guide efforts toward the elimination of HCV in this country. Future work will focus on factors associated with varying treatment and cure patterns and describing recent changes in the HCV patient landscape.

Analysis of Treated Patients by State
To investigate treatment trends further, the prevalence of nearly 90,000 treated HCV patients in 2016 was determined on a state-by-state basis. States with the highest prevalence of treated HCV patients were mainly found on the West Coast, Appalachia, the Northeast, and the Southeast, while much of the Upper Midwest and Great Plains had the lowest prevalence of treated patients 

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