Increasing Prevalence of HCC and Cirrhosis in Patients With Chronic Hepatitis C Virus Infection

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http://www.gastrojournal.org/article/PIIS0016508510018779/abstract?rss=yes

Gastroenterology

Volume 140, Issue 4 , Pages 1182-1188.e1, April 2011.

Increasing Prevalence of HCC and Cirrhosis in Patients With Chronic Hepatitis C

Virus Infection

Fasiha Kanwal

, Tuyen Hoang

, R. Kramer

, M. Asch

, Bidwell Goetz

, Angelique Zeringue

,

, Hashem B. El–Serag

Received 20 December 2009; accepted 10 December 2010. published online 23

December 2010.

Abstract

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References

ABSTRACT

Background & Aims

Patients with hepatitis C virus (HCV) infection are at risk for developing

costly and morbid complications, although the actual prevalence of these

complications is unknown. We examined time trends in the prevalence of cirrhosis

and its related complications, such as hepatic decompensation and hepatocellular

carcinoma (HCC).

Methods

We calculated the annual prevalence of cirrhosis, decompensated cirrhosis, and

HCC in a national sample of veterans diagnosed with HCV between 1996 and 2006.

Patients with HCV who had at least one physician visit in a given calendar year

were included in the analysis of prevalence for that year. We used direct

standardization to adjust the prevalence of cirrhosis and related complications

for increasing age of the cohort as well as sex and changes in clinical

characteristics.

Results

In this cohort, the number of individuals with HCV increased from 17,261 in 1996

to 106,242 in 2006. The prevalence of cirrhosis increased from 9% in 1996 to

18.5% in 2006. The prevalence of patients with decompensated cirrhosis doubled,

from 5% in 1996 to 11% in 2006, whereas the prevalence of HCC increased

approximately 20-fold (0.07% in 1996 to 1.3% in 2006). After adjustment, the

time trend in the prevalence of cirrhosis (and its complications) was lower than

the crude trend, although it still increased significantly.

Conclusions

The prevalence of cirrhosis and HCC in HCV-infected patients has increased

significantly over the past 10 years. An aging cohort of patients with HCV could

partly explain our findings. Clinicians and health care systems should develop

strategies to provide timely and effective care to this high-risk population of

patients.

[Guest guest]

http://www.gastrojournal.org/article/PIIS0016508510018779/abstract?rss=yes

Gastroenterology

Volume 140, Issue 4 , Pages 1182-1188.e1, April 2011.

Increasing Prevalence of HCC and Cirrhosis in Patients With Chronic Hepatitis C

Virus Infection

Fasiha Kanwal

, Tuyen Hoang

, R. Kramer

, M. Asch

, Bidwell Goetz

, Angelique Zeringue

,

, Hashem B. El–Serag

Received 20 December 2009; accepted 10 December 2010. published online 23

December 2010.

Abstract

Full Text

PDF

Images

References

ABSTRACT

Background & Aims

Patients with hepatitis C virus (HCV) infection are at risk for developing

costly and morbid complications, although the actual prevalence of these

complications is unknown. We examined time trends in the prevalence of cirrhosis

and its related complications, such as hepatic decompensation and hepatocellular

carcinoma (HCC).

Methods

We calculated the annual prevalence of cirrhosis, decompensated cirrhosis, and

HCC in a national sample of veterans diagnosed with HCV between 1996 and 2006.

Patients with HCV who had at least one physician visit in a given calendar year

were included in the analysis of prevalence for that year. We used direct

standardization to adjust the prevalence of cirrhosis and related complications

for increasing age of the cohort as well as sex and changes in clinical

characteristics.

Results

In this cohort, the number of individuals with HCV increased from 17,261 in 1996

to 106,242 in 2006. The prevalence of cirrhosis increased from 9% in 1996 to

18.5% in 2006. The prevalence of patients with decompensated cirrhosis doubled,

from 5% in 1996 to 11% in 2006, whereas the prevalence of HCC increased

approximately 20-fold (0.07% in 1996 to 1.3% in 2006). After adjustment, the

time trend in the prevalence of cirrhosis (and its complications) was lower than

the crude trend, although it still increased significantly.

Conclusions

The prevalence of cirrhosis and HCC in HCV-infected patients has increased

significantly over the past 10 years. An aging cohort of patients with HCV could

partly explain our findings. Clinicians and health care systems should develop

strategies to provide timely and effective care to this high-risk population of

patients.