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
. 2017 Jul;37(7):687-697.
doi: 10.1007/s40261-017-0526-z.

Disease Burden, Early Discontinuation, and Healthcare Costs in Hepatitis C Patients with and without Chronic Kidney Disease Treated with Interferon-Free Direct-Acting Antiviral Regimens

Amy Puenpatom  1 , Michael Hull  2 , Jeffrey McPheeters  3 , Kay Schwebke  3
Affiliations

Disease Burden, Early Discontinuation, and Healthcare Costs in Hepatitis C Patients with and without Chronic Kidney Disease Treated with Interferon-Free Direct-Acting Antiviral Regimens

Amy Puenpatom et al. Clin Drug Investig. 2017 Jul.

Abstract

Background: Hepatitis C virus (HCV) is a risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Direct-acting antiviral agents (DAAs) have improved HCV management in CKD patients, however real-world clinical practice data are limited.

Objective: This study examined the prevalence of CKD among HCV patients receiving oral DAAs in a real-world setting. Comorbidities, early discontinuation rates, and healthcare costs were compared between patients with and without CKD.

Methods: Patients with HCV who were treated with oral DAAs between November 2013 and June 2015, and who were enrolled in a US health plan, were identified. Early discontinuation was calculated based on observed versus expected treatment duration, and expected treatment duration was based on genotype, initial treatment regimen, baseline cirrhosis, and prior treatments. Healthcare costs were calculated during the baseline, treatment, and post-treatment periods.

Results: This study included 3438 patients receiving oral DAAs, of whom 6.9% had a CKD diagnosis. CKD patients were more often male (70.8 vs. 62.9%, p = 0.02) and older (mean age 62.0 vs. 58.8 years, p < 0.001) than non-CKD patients, and had a higher prevalence of most comorbidities. Among early discontinuers, CKD patients were more likely to experience anemia (19.4 vs. 7.7%, p = 0.028).

Conclusions: Few patients with CKD receive DAA treatment for HCV infections. HCV patients with CKD had significantly more comorbidities and higher baseline healthcare costs than patients without CKD. Compared with non-CKD patients, CKD patients were equally likely to discontinue DAA treatment early but had higher rates of anemia. This study highlights the need for more renal-friendly HCV therapies.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

Michael Hull, Jeffrey McPheeters, and Kay Schwebke are employees of Optum, while Amy Puenpatom is an employee of Merck & Co., Inc.

Funding

This study was funded in full by Merck & Co., Inc. Writing support was provided by Deja Scott-Shemon of Optum and funded by Merck & Co., Inc.

Compliance with ethics guidelines

No identifiable protected health information was used in this study, and thus it did not require Institutional Review Board approval or waiver of authorization.

Figures

Fig. 1
Fig. 1
Patient sample identification. CKD chronic kidney disease
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Li WC, Lee YY, Chen IC, Wang SH, Hsiao CT, Loke SS. Age and gender differences in the relationship between hepatitis C infection and all stages of Chronic kidney disease. J Viral Hepat. 2014;21(10):706–715. doi: 10.1111/jvh.12199. - DOI - PubMed
    1. Chen YC, Lin HY, Li CY, Lee MS, Su YC. A nationwide cohort study suggests that hepatitis C virus infection is associated with increased risk of chronic kidney disease. Kidney Int. 2014;85(5):1200–1207. doi: 10.1038/ki.2013.455. - DOI - PubMed
    1. Lee JJ, Lin MY, Chang JS, Hung CC, Chang JM, Chen HC, et al. Hepatitis C virus infection increases risk of developing end-stage renal disease using competing risk analysis. PloS One. 2014;9(6):e100790. doi: 10.1371/journal.pone.0100790. - DOI - PMC - PubMed
    1. Lee JJ, Lin MY, Yang YH, Lu SN, Chen HC, Hwang SJ. Association of hepatitis C and B virus infection with CKD in an endemic area in Taiwan: a cross-sectional study. Am J Kidney Dis. 2010;56(1):23–31. doi: 10.1053/j.ajkd.2010.01.015. - DOI - PubMed
    1. Dai CY, Yeh ML, Huang CF, Hou CH, Hsieh MY, Huang JF, et al. Chronic hepatitis C infection is associated with insulin resistance and lipid profiles. J Gastroenterol Hepatol. 2015;30(5):879–884. doi: 10.1111/jgh.12313. - DOI - PubMed

Substances

LinkOut - more resources