Bristol-Myers Squibb, Uxbridge, UK.
Health Economics and Outcomes Research, Cardiff, UK.
BMJ Open. 2019 Aug 5;9(8):e029066. doi: 10.1136/bmjopen-2019-029066.
To evaluate the impact of treatment with new direct-acting antivirals (DAAs) on the prevalent hepatitis C virus (HCV) population in England.
A repeated cross-sectional analysis.
Four secondary care hospitals in England.
Patients who, in 2015 and/or 2016, had chronic HCV infection and were alive were eligible, regardless of the type of HCV intervention received.
Data including intravenous drug use (IVDU) status, HCV genotype, cirrhosis status, HCV treatment history, vital status and treatment outcomes were collected at two time points in 2015 and 2016 using electronic case report forms.
There were 1605 and 1355 patients with active chronic HCV in 2015 and 2016, respectively. Between 2015 and 2016, the proportion of patients with current IVDU increased (10.3% vs 14.5%, respectively), while that of patients with cirrhosis (28.2% vs 22.4%) and treatment-experienced patients (31.2% vs 27.1%) decreased. Among patients whose treatment outcome was known by 2016, high cure rates were observed, with an overall sustained virological response rate of 93.2%. From 2015 to 2016, there was a progressive increase in the proportion of treated patients who were non-cirrhotic, with current IVDU and non-liver transplant recipients.
The characteristics of patients with HCV remaining in contact with specialised care evolved with a changing landscape of treatment and related health policy. With increasing access to DAAs in UK, high cure rates were achieved in the study cohort.
评估新型直接作用抗病毒药物（DAAs）治疗对英国流行丙型肝炎病毒（HCV）人群的影响。
重复横断面分析。
英国四家二级保健医院。
2015 年和/或 2016 年患有慢性 HCV 感染且存活的患者符合条件，无论接受何种类型的 HCV 干预措施。
使用电子病例报告表，在 2015 年和 2016 年的两个时间点收集包括静脉吸毒（IVDU）状况、HCV 基因型、肝硬化状况、HCV 治疗史、生死状况和治疗结局在内的数据。
2015 年和 2016 年分别有 1605 例和 1355 例活动性慢性 HCV 患者。2015 年至 2016 年期间，当前 IVDU 患者的比例增加（分别为 10.3%和 14.5%），而肝硬化患者（28.2%和 22.4%）和治疗经验丰富的患者（31.2%和 27.1%）的比例下降。到 2016 年，已知治疗结局的患者中，高治愈率，总体持续病毒学应答率为 93.2%。2015 年至 2016 年，非肝硬化、当前有 IVDU 和非肝移植患者的治疗患者比例逐渐增加。
与专门护理保持联系的 HCV 患者的特征随着治疗和相关卫生政策的变化而变化。随着英国 DAA 的广泛应用，研究队列中实现了高治愈率。
