Hepatitis C Genotype Makes a Difference in Liver Disease, Study Shows

Patients with hepatitis C genotype 3 may face more liver problems.

A recent analysis suggests that liver disease and treatment costs for people with hepatitis C varies depending on a patient’s genotype—and people with genotype 3 appear to have a greater severity of liver disease.

Researchers analyzed data from selected health insurance claims in the United States, and identified varying disease progression and healthcare costs based on genotype.

“This study provides evidence of variation by hepatitis C genotype in liver and non-liver related comorbidities, liver disease severity, and healthcare costs,” the authors wrote in the journal Current Medical Research and Opinion.

Chronic hepatitis C infection can cause serious liver damage, cirrhosis, and also lead to liver cancer. There are six major strains, or genotypes, of the virus. While genotype 1 is the most prevalent in the United States, genotype 3 appears to be the most difficult to treat.

The retrospective study collected data on patient demographic and clinical characteristics provided in healthcare claims from a large US health plan and laboratory data. All patients had at least 18 months of a continuous pharmacy and medical insurance. Potential participants were excluded if age, sex, geographic region, and health insurance were unknown.

Most of the patients were male (63.5%) and average age came out to 50.6 years. Out of the more than 10,000 patients included in the review, 79.1% had genotype 1, 12.8% had genotype 2, and 8.1% had genotype 3.

Patients with genotype 3 had the highest percentage of liver-related comorbidities and advanced liver disease. They were about one-third more likely to have advanced liver disease than were patients with the genotype 1 strain of the virus. The highest rates of steatosis, liver transplant, and hepatocellular carcinoma (the most common form of liver cancer) were also among patients with genotype 3.

“These findings support the notion that genotype 3 variant of the virus imparts a unique pathophysiology throughout the disease course,” the authors stated, also noting that the findings were similar to previous studies.

Those with genotype 1 took the hardest financial hit with the highest all-cause costs, while genotype 2 patients had the lowest costs and lower healthcare resource utilization.

“These differences may reflect differing rates of non-liver-related comorbidities and all-cause care,” the authors explained. “Multivariable analyses showed that genotype was a significant predictor of costs and liver disease severity: compared with patients having genotype 1, those with genotype 3 were significantly more likely to have advanced liver disease. Patients with genotype 2 were significantly less likely to have advanced disease and more likely to have lower all-cause costs.”

One limitation of the study is that results may not generally represent other patients outside the represented insurance plans, the authors noted.

“The findings highlight the importance of effective hepatitis C treatment for all patients and support guidelines for treatment of high-risk patients,” including patients with genotype 3 of the virus, the team concluded.

The study, “Clinical characteristics, healthcare costs, and resource utilization in hepatitis C vary by genotype,” was published in Current Medical Research and Opinion, and was sponsored by Bristol-Myers Squibb.

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