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Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries
Background and Aim Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify pat...
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Published in: | Journal of gastroenterology and hepatology 2015-02, Vol.30 (2), p.364-371 |
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container_title | Journal of gastroenterology and hepatology |
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creator | Marcellin, Patrick Grotzinger, Kelly Theodore, Dickens Demuth, Dirk Manns, Michael Bañares Cañizares, Rafael Pike, James Forssen, Ulla M |
description | Background and Aim
Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five European countries.
Methods
This cross‐sectional study retrospectively reviewed the medical records of patients who were chronically infected with HCV in 2006. Patients managed for HCV at any of 60 sites in France, Germany, Italy, Spain, and the UK were included. Data collected included patient demographics and clinical characteristics. A combination of univariate and multivariate regression analyses were used to identify predictors of fibrosis severity and factors associated with undergoing biopsy.
Results
Four thousand five hundred and ninety‐four chronically infected HCV patients were included in this analysis. Management approaches differed between countries, with variations in biopsy use (59.3–18.4%) and preferred fibrosis scoring systems. Where histology results were available, 43.4%, 23.8%, and 32.9% had mild, moderate, and severe fibrosis, respectively. Factors associated with undergoing a biopsy included male gender and co‐infection with hepatitis B virus. Chronic alcoholism, a lower first platelet count, and older age were predictors of increased liver fibrosis severity.
Conclusions
These data suggest that there are major differences in how specialists manage their HCV patients across five major European countries. |
doi_str_mv | 10.1111/jgh.12698 |
format | article |
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Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five European countries.
Methods
This cross‐sectional study retrospectively reviewed the medical records of patients who were chronically infected with HCV in 2006. Patients managed for HCV at any of 60 sites in France, Germany, Italy, Spain, and the UK were included. Data collected included patient demographics and clinical characteristics. A combination of univariate and multivariate regression analyses were used to identify predictors of fibrosis severity and factors associated with undergoing biopsy.
Results
Four thousand five hundred and ninety‐four chronically infected HCV patients were included in this analysis. Management approaches differed between countries, with variations in biopsy use (59.3–18.4%) and preferred fibrosis scoring systems. Where histology results were available, 43.4%, 23.8%, and 32.9% had mild, moderate, and severe fibrosis, respectively. Factors associated with undergoing a biopsy included male gender and co‐infection with hepatitis B virus. Chronic alcoholism, a lower first platelet count, and older age were predictors of increased liver fibrosis severity.
Conclusions
These data suggest that there are major differences in how specialists manage their HCV patients across five major European countries.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.12698</identifier><identifier>PMID: 25088088</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Adult ; Alcoholism ; Biopsy - statistics & numerical data ; Coinfection ; Cross-Sectional Studies ; Europe ; Europe - epidemiology ; Female ; Fibrosis ; Forecasting ; Hepatitis ; hepatitis C ; Hepatitis C, Chronic - epidemiology ; Hepatitis C, Chronic - pathology ; Humans ; Liver - pathology ; liver fibrosis severity ; Male ; Middle Aged ; Multivariate Analysis ; Observational Studies as Topic ; observational study ; Platelet Count ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>Journal of gastroenterology and hepatology, 2015-02, Vol.30 (2), p.364-371</ispartof><rights>2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd</rights><rights>2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3638-e518df449910665ce5b033aa93989a201c051466fe36eba9d388b9336d90055c3</citedby><cites>FETCH-LOGICAL-c3638-e518df449910665ce5b033aa93989a201c051466fe36eba9d388b9336d90055c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25088088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marcellin, Patrick</creatorcontrib><creatorcontrib>Grotzinger, Kelly</creatorcontrib><creatorcontrib>Theodore, Dickens</creatorcontrib><creatorcontrib>Demuth, Dirk</creatorcontrib><creatorcontrib>Manns, Michael</creatorcontrib><creatorcontrib>Bañares Cañizares, Rafael</creatorcontrib><creatorcontrib>Pike, James</creatorcontrib><creatorcontrib>Forssen, Ulla M</creatorcontrib><title>Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five European countries.
Methods
This cross‐sectional study retrospectively reviewed the medical records of patients who were chronically infected with HCV in 2006. Patients managed for HCV at any of 60 sites in France, Germany, Italy, Spain, and the UK were included. Data collected included patient demographics and clinical characteristics. A combination of univariate and multivariate regression analyses were used to identify predictors of fibrosis severity and factors associated with undergoing biopsy.
Results
Four thousand five hundred and ninety‐four chronically infected HCV patients were included in this analysis. Management approaches differed between countries, with variations in biopsy use (59.3–18.4%) and preferred fibrosis scoring systems. Where histology results were available, 43.4%, 23.8%, and 32.9% had mild, moderate, and severe fibrosis, respectively. Factors associated with undergoing a biopsy included male gender and co‐infection with hepatitis B virus. Chronic alcoholism, a lower first platelet count, and older age were predictors of increased liver fibrosis severity.
Conclusions
These data suggest that there are major differences in how specialists manage their HCV patients across five major European countries.</description><subject>Adult</subject><subject>Alcoholism</subject><subject>Biopsy - statistics & numerical data</subject><subject>Coinfection</subject><subject>Cross-Sectional Studies</subject><subject>Europe</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Forecasting</subject><subject>Hepatitis</subject><subject>hepatitis C</subject><subject>Hepatitis C, Chronic - epidemiology</subject><subject>Hepatitis C, Chronic - pathology</subject><subject>Humans</subject><subject>Liver - pathology</subject><subject>liver fibrosis severity</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Observational Studies as Topic</subject><subject>observational study</subject><subject>Platelet Count</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kE1PGzEQhq2qqKS0B_5A5SM9LNjrj9jcUESTIkQrtRUVF8vrnSWmGzu1d2lz60_HEMito5FmNHrmObwIHVJyTEud3N0uj2kttXqFJpRzUtEpl6_RhCgqKs2o3kdvc74jhHAyFW_Qfi2IUqUn6N83uIfkhw2OHe592XHrM9gM2K5iuMVumWLwDi9hbQc_-Ixn-HGDMORTfBZwbDKk-3KJwfY4D2P75OJC8x2IfcBdkePzMcU12IBdHMOQPOR3aK-zfYb3z_MA_fh0_n22qC6_zD_Pzi4rxyRTFQiq2o5zrSmRUjgQDWHMWs200rYm1BFBuZQdMAmN1S1TqtGMyVYTIoRjB-ho612n-HuEPJiVzw763gaIYzZUipozJURd0I9b1KWYc4LOrJNf2bQxlJjHwE0J3DwFXtgPz9qxWUG7I18SLsDJFvjje9j832Qu5osXZbX98HmAv7sPm34ZOWVTYa6v5obefL3WdFGbn-wBS2aZdg</recordid><startdate>201502</startdate><enddate>201502</enddate><creator>Marcellin, Patrick</creator><creator>Grotzinger, Kelly</creator><creator>Theodore, Dickens</creator><creator>Demuth, Dirk</creator><creator>Manns, Michael</creator><creator>Bañares Cañizares, Rafael</creator><creator>Pike, James</creator><creator>Forssen, Ulla M</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201502</creationdate><title>Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries</title><author>Marcellin, Patrick ; Grotzinger, Kelly ; Theodore, Dickens ; Demuth, Dirk ; Manns, Michael ; Bañares Cañizares, Rafael ; Pike, James ; Forssen, Ulla M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3638-e518df449910665ce5b033aa93989a201c051466fe36eba9d388b9336d90055c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Alcoholism</topic><topic>Biopsy - statistics & numerical data</topic><topic>Coinfection</topic><topic>Cross-Sectional Studies</topic><topic>Europe</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Forecasting</topic><topic>Hepatitis</topic><topic>hepatitis C</topic><topic>Hepatitis C, Chronic - epidemiology</topic><topic>Hepatitis C, Chronic - pathology</topic><topic>Humans</topic><topic>Liver - pathology</topic><topic>liver fibrosis severity</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Observational Studies as Topic</topic><topic>observational study</topic><topic>Platelet Count</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marcellin, Patrick</creatorcontrib><creatorcontrib>Grotzinger, Kelly</creatorcontrib><creatorcontrib>Theodore, Dickens</creatorcontrib><creatorcontrib>Demuth, Dirk</creatorcontrib><creatorcontrib>Manns, Michael</creatorcontrib><creatorcontrib>Bañares Cañizares, Rafael</creatorcontrib><creatorcontrib>Pike, James</creatorcontrib><creatorcontrib>Forssen, Ulla M</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marcellin, Patrick</au><au>Grotzinger, Kelly</au><au>Theodore, Dickens</au><au>Demuth, Dirk</au><au>Manns, Michael</au><au>Bañares Cañizares, Rafael</au><au>Pike, James</au><au>Forssen, Ulla M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2015-02</date><risdate>2015</risdate><volume>30</volume><issue>2</issue><spage>364</spage><epage>371</epage><pages>364-371</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five European countries.
Methods
This cross‐sectional study retrospectively reviewed the medical records of patients who were chronically infected with HCV in 2006. Patients managed for HCV at any of 60 sites in France, Germany, Italy, Spain, and the UK were included. Data collected included patient demographics and clinical characteristics. A combination of univariate and multivariate regression analyses were used to identify predictors of fibrosis severity and factors associated with undergoing biopsy.
Results
Four thousand five hundred and ninety‐four chronically infected HCV patients were included in this analysis. Management approaches differed between countries, with variations in biopsy use (59.3–18.4%) and preferred fibrosis scoring systems. Where histology results were available, 43.4%, 23.8%, and 32.9% had mild, moderate, and severe fibrosis, respectively. Factors associated with undergoing a biopsy included male gender and co‐infection with hepatitis B virus. Chronic alcoholism, a lower first platelet count, and older age were predictors of increased liver fibrosis severity.
Conclusions
These data suggest that there are major differences in how specialists manage their HCV patients across five major European countries.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25088088</pmid><doi>10.1111/jgh.12698</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Alcoholism Biopsy - statistics & numerical data Coinfection Cross-Sectional Studies Europe Europe - epidemiology Female Fibrosis Forecasting Hepatitis hepatitis C Hepatitis C, Chronic - epidemiology Hepatitis C, Chronic - pathology Humans Liver - pathology liver fibrosis severity Male Middle Aged Multivariate Analysis Observational Studies as Topic observational study Platelet Count Retrospective Studies Severity of Illness Index |
title | Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries |
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