Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;27(1):20-27.
doi: 10.1111/jvh.13203. Epub 2019 Oct 3.

Data linkage to monitor hepatitis C-associated end-stage liver disease and hepatocellular carcinoma inpatient stays in England

Georgina Ireland  1   2 , Ruth Simmons  1   2 , Matthew Hickman  3   4 , Ross Harris  1 , Mary Ramsay  1 , Caroline Sabin  5 , Sema Mandal  1   2
Affiliations

Data linkage to monitor hepatitis C-associated end-stage liver disease and hepatocellular carcinoma inpatient stays in England

Georgina Ireland et al. J Viral Hepat. 2020 Jan.

Abstract

Persons with chronic hepatitis C (HCV) infection are at increased risk of end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC). The impact of hepatitis treatment scale-up and elimination strategies on ESLD and HCC incidence is a critical measure of progress towards WHO targets. Data from national laboratory surveillance of HCV diagnoses were linked to inpatient care records in Hospital Episode Statistics (HES). For persons first diagnosed with HCV between 1998 and 2016, we describe the characteristics of those with ESLD and HCC and estimate incidence. Of persons diagnosed with HCV between 1998 and 2016 (104 674), 9.1% (9525) had an admission for ESLD and 2.5% (2610) for HCC. The majority of persons with ESLD and HCC were male (70.7% and 82.7%) and of white ethnicity (89.9% and 82.7%). Crude incidence of ESLD and HCC admission was 10.4 and 3.2 per 1000 person-years, respectively. When compared to 2011-2013, incidence of ESLD and HCC admissions in 2014-2017 were lower (ESLD incidence rate ratio [IRR]: 0.81; 95% Confidence interval [CI]: 0.76-0.86; HCC IRR: 0.90; 95% CI: 0.82-1.00, P = .045). Data linkage showed considerable underreporting of HCV in HES coding for ESLD and HCC (16.0% and 11.3%, respectively). In conclusion, we found a decline in incidence of ESLD and HCC-related inpatient admissions since 2011-2013. Linked analysis is required for the continued monitoring of ESLD and HCC inpatient incidence. However, HES data quality issues around completeness of identifiers contribute to uncertainty in linkage and may limit our ability to robustly monitor progress towards WHO elimination goals.

Keywords: end stage liver disease; hepatitis c; hepatocellular carcinoma; inpatient.

PubMed Disclaimer

References

REFERENCES

    1. Harris RJ, Harris H, Mandal S, et al. Monitoring the hepatitis C epidemic in England and evaluating intervention scale-up using routinely collected data. J Viral Hepat. 2019;26(5):541-551.
    1. Singal AG, Volk ML, Jensen D, Di Bisceglie AM, Schoenfeld PS. A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with hepatitis C virus. Clin Gastroenterol Hepatol. 2010;8(3):280-288.e1.
    1. Simmons B, Saleem J, Heath K, Cooke GS, Hill A. Long-term treatment outcomes of patients infected with hepatitis C virus: A systematic review and meta-analysis of the survival benefit of achieving a sustained virological response. Clin Infect Dis. 2015;61(5):730-740.
    1. Vaziri A, Gimson A, Agarwal K, et al. Liver transplant listing for hepatitis C associated cirrhosis and hepatocellular carcinoma has fallen in the United Kingdom since the introduction of direct acting antiviral therapy. J Viral Hepat. 2018;26(2):231-235.
    1. Public Health England. Hepatitis C in England- 2018 report. Working to eliminate hepatitis C as a major public health threat. 2018.

Publication types

MeSH terms

LinkOut - more resources