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Antiviral therapy during compensated cirrhosis most cost-effective approach
Date:5/27/2010

Researchers at the UCLA Medical Center found that antiviral therapy during compensated cirrhosis, when compared with all other strategies, is the most cost-effective approach to treating patients with advanced liver disease due to hepatitis C (HCV) infection. Full details appear in the June issue of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).

HCV is generally treated once significant scarring has occurred but before patients develop advanced scarring, i.e. cirrhosis. The standard antiviral regimen used to treat HCVpegylated interferon and ribavirin (PEG/RBV)can cause harsh side effects and is considered by some medical professionals to be of uncertain benefit in patients with advanced liver disease.

Furthermore, HCV genotype 1, the type that afflicts most HCV patients, is least responsive to antiviral treatment. According to the HCV Advocate, genotype is the most important predictor of successful treatment response and also dictates the dose of ribavirin and length of therapy. People with genotype 1 have about a 50% chance of successful treatment and people with genotypes 2 or 3 have about a 70-90% chance of a successful treatment response. In addition, people with genotypes 2 or 3 are prescribed a lower dose of ribavirin than people with genotype 1.

Using a Markov model, the UCLA team set out to determine the most cost-effective timing for PEG/RBV therapy in patients with advanced liver disease infected with genotype 1 HCV by comparing treatment at different stages of advanced HCV disease over a 17-year period.

The study population of 4,000 patients was evenly divided into 4 different treatment strategies. The control group did not receive antiviral treatment. In the first treatment strategy, antiviral treatment was initiated in patients with compensated HCV cirrhosis. In the second treatment strategy, patients were t
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Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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