Trends in liver transplantation for hepatitis C in a country with reduced access to direct‐acting antiviral agents
Background Hepatitis C virus (HCV)‐related cirrhosis is a leading indication for liver transplantation (LT) worldwide. Access to effective HCV treatment is inequitable globally. We aimed to analyze whether the introduction of effective HCV treatment caused an impact in LT trends in a middle‐income c...
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Published in | Clinical transplantation Vol. 32; no. 4; pp. e13230 - n/a |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Denmark
01.04.2018
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Subjects | |
Online Access | Get full text |
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Summary: | Background
Hepatitis C virus (HCV)‐related cirrhosis is a leading indication for liver transplantation (LT) worldwide. Access to effective HCV treatment is inequitable globally. We aimed to analyze whether the introduction of effective HCV treatment caused an impact in LT trends in a middle‐income country.
Methods
Cross‐sectional analysis of all adult patients who were listed/received a LT in Argentina for HCV, alcohol‐related liver disease (ALD), or autoimmune hepatitis/primary biliary cirrhosis (AIH/PBC) from 2007 to 2017. Joinpoint regression analysis was used to identify changes in the cumulative incidence rates in waiting list (WL) registration, WL mortality, and LT.
Results
Liver transplantation WL for HCV increased significantly between 2007 and 2014, with an annual percentage change (APC) +7.8%, P = .01, followed by a downward slope from 2014 to 2017 with an APC −9.8%, P = .1. There were no significant changes in WL mortality. LT trends remained stable. LT for HCV without MELD exception points for HCC decreased (APC −6.6%, P = .01), whereas LT for HCV with HCC exception points increased (APC +11.1, P = .01) during the study period.
Conclusion
Waiting list and LT for HCV without HCC decreased, whereas LT for HCV and HCC increased; this may be related to selective antiviral treatment access for patients with advanced fibrosis. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0902-0063 1399-0012 |
DOI: | 10.1111/ctr.13230 |