Abstract
BackgroundThe World Health Organization has called for global and regional assessments of the burden of hepatitis C (HCV) along with country-specific patient profiles to better inform healthcare policy. The present investigated the characteristics and burden of patients reporting a diagnosis of HCV infection in the US, France, Germany, Italy, Spain, the UK, urban China, and Japan using a consistent methodology of patient-reported surveys.MethodsThe 2010 5EU (N = 57,805), 2009 US (N = 75,000), 2008/2009 Japan (N = 37,683), and 2009/2010 urban China (N = 33,261) waves of the National Health and Wellness Survey were used as the data source. Within each country, patients with a self-reported diagnosis of HCV were compared with those who did not report a diagnosis of HCV on sociodemographics, health behaviors, comorbidities, and health outcomes (e.g., Short Form-12v2). The effect of HCV was examined using regression analysis applying sampling weights.ResultsThe prevalence of HCV ranged from 0.26% (China) to 1.42% (Italy). Patients in Japan and Italy (61.60 and 61.02 years, respectively) were the oldest, while patients in the US were the most likely to be obese (39.31%) and have concomitant anxiety (38.43%) and depression (46.05%) compared with other countries. Pooling countries and adjusting for sociodemographics, health behaviors, and comorbidities, HCV was associated with significantly lower physical component summary scores (b = −2.51) and health utilities (b = −0.04) and greater overall work impairment (b = 8.79), physician visits (b = 2.91), and emergency department visits (b = 0.30) (all p<.05). The effects on health status were strongest in the US and UK while the effects on healthcare resource use were strongest in Japan.ConclusionsHCV was associated with a significant humanistic and economic burden. These results suggest that the manifestation of the HCV burden, and the profile of the patients themselves, varied dramatically by country. Successful disease management should be cognizant of region-specific unmet needs.
Highlights
85% of patients who are infected with the hepatitis C virus (HCV) develop chronic HCV infection [1]
Studies outside the United States (US) have drawn similar conclusions. In some studies, such as those conducted in Germany, Italy, and Japan, health status scores from patients with HCV have been compared with population norms, highlighting the burden associated with infection [8,9,10]
More than half of respondents who reported a diagnosis of HCV were male in each country (Italy: 54.76% male to Spain: 67.39% male), the pattern was reversed in France, where only 36.03% of respondents who reported a diagnosis were male
Summary
85% of patients who are infected with the hepatitis C virus (HCV) develop chronic HCV infection [1]. Studies outside the US have drawn similar conclusions In some studies, such as those conducted in Germany, Italy, and Japan, health status scores from patients with HCV have been compared with population norms, highlighting the burden associated with infection [8,9,10]. Hauser et al (2004), for example, showed that patients with chronic HCV in Germany reported mean physical and mental summary scores (from the Short Form-36, a longer form of the Short Form-12 described above) of 40.94 and 43.21, respectively, both lower than the population mean of 50 [8] In other studies, such as those in Spain, the United Kingdom (UK), and China, health status scores were compared between patients with HCV and non-HCV controls, providing support for the deleterious effect HCV can have on mental and physical functioning [11,12,13]. The present investigated the characteristics and burden of patients reporting a diagnosis of HCV infection in the US, France, Germany, Italy, Spain, the UK, urban China, and Japan using a consistent methodology of patient-reported surveys
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