PIN6 - Long-Term Outcomes of Chronic Hepatitis C in the Population of Newly Diagnosed Russian Patients

Abstract

To predict the future incidence of chronic hepatitis C in Russia and assess potential impact of the available antiviral therapies (pegylated interferon a-2a/a-2b or standard interferon a-2b combined with ribavirin) on long-term morbidity and mortality rates in the population of newly diagnosed Russian patients with chronic hepatitis C. Based on the national epidemiologic data and published natural history studies, the prognostic Markov model was developed. Depending on the results of antiviral therapy, patients’ flows over 25-year time frame were simulated. End points of interests included: the incidence of compensated and decompensated cirrhosis, hepatocellular carcinoma and cumulative time that patients will spend in each state, the number of patients, who will require liver transplantation, and HCV-related mortality rates. During years 2013-2017 about 276,000 new cases of chronic hepatitis C will be diagnosed in Russia. After 25 years since being diagnosed 130, 189 and 227 of 1,000 patients received pegylated interferon a-2a, pegylated interferon a-2b and standard interferon a-2b, respectively, will develop compensated cirrhosis. The cumulative time that patients will spend in compensated cirrhosis state will be 848, 1,218 and 1,482 patient-years, respectively. During the established time frame, there will be expected 25, 36 and 43 cases of hepatocellular carcinoma and 35, 51 and 62 HCV-related deaths. 28, 40 and 49 patients, respectively, will require liver transplantation. The findings from the present study provide the opportunity to plan volumes of medical care that will be required to Russian patients with chronic hepatitis C during 25 years since disease was first diagnosed. The treatment with pegylated interferon alfa-2a is considered the most preferable strategy due to considerably lower long-term morbidity and mortality rates as compared to pegylated interferon a-2b and standard interferon a-2b treatment.