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. 2021 Jan;41(1):33-47.
doi: 10.1111/liv.14670.

Peri-complication diagnosis of hepatitis C infection: Risk factors and trends over time

Lauren Lapointe-Shaw  1   2   3   4 , Hannah Chung  3 , Beate Sander  2   3   4   5   6 , Jeffrey C Kwong  3   4   5   7   8 , Laura Holder  3 , Orlando Cerocchi  4 , Peter C Austin  2   3 , Jordan J Feld  1   4   9
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Peri-complication diagnosis of hepatitis C infection: Risk factors and trends over time

Lauren Lapointe-Shaw et al. Liver Int. 2021 Jan.

Abstract

Background & aims: Hepatitis C virus (HCV) is a common and treatable cause of cirrhosis and its complications, yet many chronically infected individuals remain undiagnosed until a late stage. We sought to identify the frequency of and risk factors for HCV diagnosis peri-complication, that is within six months of an advanced liver disease complication.

Methods: This was a retrospective cohort study of Ontario residents diagnosed with chronic HCV infection between 2003 and 2014. HCV diagnosis peri-complication was defined as the occurrence of decompensated cirrhosis, hepatocellular carcinoma or liver transplant within ±6 months of HCV diagnosis. Multivariable logistic regression was used to identify risk factors for peri-complication diagnosis among all those diagnosed with HCV infection.

Results: Our cohort included 39,515 patients with chronic HCV infection, of whom 4.2% (n = 1645) were diagnosed peri-complication; these represented 31.6% of the 5,202 patients who developed complications in the follow-up period. Peri-complication diagnosis became more common over the study period and was associated with increasing age among baby boomers, alcohol use, diabetes mellitus, chronic HBV co-infection and moderate to high levels of morbidity. Female sex, immigrant status, having more previous outpatient physician visits, a previous emergency department visit, a history of drug use or mental health visits were associated with reduced risk of peri-complication diagnosis.

Conclusions: Over a quarter of HCV-infected patients with complications were diagnosed peri-complication. This problem increased over time, suggesting a need to further expand HCV screening.

Keywords: cirrhosis; screening; temporal trends; viral hepatitis.

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References

REFERENCES

    1. Public Health Agency of Canada. Report on Hepatitis B and C in Canada: 2014. 2017; https://www.canada.ca/en/services/health/publications/diseases-condition....
    1. World Health Organization. Global Hepatitis Report. Geneva; 2017.
    1. Feld JJ, Liang TJ. Hepatitis C - identifying patients with progressive liver injury. Hepatology (Baltimore, MD). 2006;43(2 Suppl 1):S194-S206.
    1. 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.
    1. Afdhal N, Zeuzem S, Kwo P, et al. Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Eng J Med. 2014;370(20):1889-1898.

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