The burden of hepatitis C in Europe from the patients’ perspective: a survey in 5 countries

<p>Abstract</p> <p>Background</p> <p>Few studies have examined the impact of Hepatitis C virus (HCV) infection on patient reported outcomes in Europe. This study was conducted to assess the burden of HCV infection in terms of work productivity loss, activity impairment, health-related quality of life, healthcare resource utilization, and associated costs.</p> <p>Methods</p> <p>The 2010 European National Health and Wellness Survey (n = 57,805) provided data. Patients reporting HCV infection in France, Germany, the UK, Italy, and Spain were matched to respondents without HCV using propensity scores. Outcome measures included the Work Productivity and Activity Impairment (WPAI) questionnaire and the Medical Outcomes Study Short Form-12 (SF-12v2) questionnaire. Subgroup analyses focused on treatment-naïve patients.</p> <p>Results</p> <p>HCV Patients (<it>n</it> = 286) had more work impairment (30% vs. 18%, <it>p</it> < .001), more impairment in non-work activities (34% vs. 28%, <it>p</it> < .05), and more annual physician visits per patient (19.8 vs. 13.3, <it>p</it> < .001). Estimated indirect and direct costs were €2,956 (<it>p</it> < .01) and €495 (<it>p</it> < .001) higher than in matched controls, respectively. Health-related quality of life was also lower among HCV patients. Treatment-naïve HCV patients (<it>n</it> = 139) also reported higher work impairment (29% vs. 15%, <it>p</it> < .01), as well as more frequent physician visits (19.5 vs. 12.1, <it>p</it> < .01) than matched controls. Each treatment-naïve HCV infected patient incurred €934 in direct costs vs. €508 (<it>p</it> < .01 in matched controls. Employed treatment-naïve patients reported higher productivity loss per year compared to matched controls (€6,414 vs. €3,642, <it>p</it> < .05).</p> <p>Conclusion</p> <p>HCV infection in Europe is associated with considerable economic and humanistic burden. This is also true of diagnosed patients who have never been treated for HCV.</p

Serum Interferon-Related MicroRNAs as Biomarkers to Predict the Response to Interferon Therapy in Chronic Hepatitis C Genotype 4

MicroRNAs are messengers during interferon-virus interplay and are involved in antiviral immunity, however, little is known about interferon-related microRNAs regarding their detection in serum and their potential use as non-invasive diagnostic and prognostic biomarkers in chronic hepatitis C (CHC). To elucidate some of the molecular aspects underlying failure of pegylated interferon-α/ribavirin therapy, we investigated pretreatment expression profiles of seven selected interferon-related microRNAs (miR-146a, miR-34a, miR-130a, miR-19a, miR-192, miR-195, and miR-296) by quantitative RT-PCR custom array technology in serum of Egyptian CHC genotype 4 patients and whether their pretreatment levels would predict patient response to the combination therapy. One hundred and six CHC patients and forty matched healthy controls were included. Patients were divided into sustained virological response (SVR) and non-responder (NR) groups. Serum miR-34a, miR-130a, miR-19a, miR-192, miR-195, and miR-296 were upregulated, whereas serum miR-146a was downregulated in CHC compared to controls. Significant correlations were found between expression levels of studied microRNAs and also with clinical data. Pretreatment levels of miR-34a, miR-130a, and miR-195 were significantly higher, whereas miR-192 and miR-296 levels were significantly lower in SVR than NR patients. miR-19a and miR-146a levels were not significantly different between the two groups. miR-34a was superior to differentiate CHC from controls, whereas miR-296 was superior to discriminate SVR from NR patients by receiver operating characteristic analysis. Multivariate logistic analysis revealed miR-34a and miR-195 as independent predictors for SVR and miR-192 as an independent variable for non-response. In conclusion, pretreatment expression profiles of five interferon-related microRNAs are associated with treatment outcome in CHC. Of these, miR-34a, miR-195, and miR-192 could predict treatment response. The profiling results could be used as novel non-invasive diagnostic and prognostic pharmacogenetic biomarkers for treatment personalization in CHC and could help to identify new microRNA-based antivirals