icon-folder.gif   Conference Reports for NATAP  
  EASL 46th Annual Meeting
March 30th - April 3rd 2011
Berlin, Germany
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Increasing & Peaking Cirrhosis, Decompensated
Cirrhosis & HCC(liver cancer) in UK Projected

  from Jules: these projections are no different as what has been projected in the USA. The HCV epidemic started 30 years ago so infected patients' disease obviously has been advancing to now where it's estimated advanced liver disease is peaking & death rates will increase over the next 12 years leaving an approaching brief window to identify undiagnosed patients (its estimated that two-thirds to three-fourths of patients remain undiagnosed), and to provide care & treatment. This epidemiologic event dovetails with emerging new anticiapted high cure rates due to the many new HCV treatments emerging beginning now with 10-15 new drugs in development. Within several years we expect like in HIV multi-drug antiviral orally administered therapy. The most recent research development was presented in a study at EAL the European annual liver conference in April 2011 reporting patients were cured with a combination of 2 oral drugs without peginterferon/ribavirin (these were prior null responder patients the hardest to treat) which provides proof of concept that at least some patients can be cured without peg/rbv, perhaps all, so ongoing studies will be trying to confirm the extent of this possibility.
Estimating the incidence and prevalence of Hepatitis C infection in England using backprojection methods - see attached full poster report
EASL: Brief Recap Report from EASL Liver Conference in Berlin: state of HCV Now- policy, treatment, access - (04/04/11)
At EASL there was a panel discussion on global HCV, participating on the panel were Jake Liang from the US NIH and John Ward from the US CDC and a someone from WHO......The HHS HCV Strategy plan is expected to be publicly unveiled in May.....There are no large-scales HCV testing & screening programs from the fed, the states or from cities......I estimate as many as 8 million people in the USA have HCV..... large part because of potentially high rates of HCV-infection of immigrants to the USA. as many as 500,000+ in NYC. Immigrant communities include Russians, various Asian communities, Africans, immigrants from various Indian peninsula countries and of course China.
EASL: Burden of viral hepatitis C in Europe: a propensity analysis of patient outcomes - (04/09/11)
presence of HCV is associated with detriments in quality of life and increased levels of work productivity loss and healthcare resource use among the adult EU population
EASL: Cost Benefit Analysis of Response Guided Therapy: Dynamic Disease Markov Modeling for Patients with Chronic Hepatitis CVirus (HCV) by Fibrosis Stages - (04/09/11)
RGT is a cost-effective alternative to SDT (standard duration therapy) in patients with CHC. This result is primarily driven by the substantial cost savings in the RGT arm which were a result of shorter treatment times in those patients achieving RVR.
Reported by Jules Levin
EASL 2011 April Berlin Germany
Phil McEwan1,2 Yuan Y3 and Kim R4
1. Centre for Health Economics, Swansea University, Wales, 2. Cardiff Research Limited, Cardiff, UK, 3. Global Health Outcomes and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, 4. Mayo Clinic College of Medicine, Rochester, MN, US. This study was sponsored by Bristol-Myers Squibb (Bristol-Myers Squibb, Princeton, NJ, US)
'the numbers of individuals who have advanced to F3 has been on the rise since 1995 and is at its highest in this graph at 2010 (Figure 2)'
'number of patients with HCV disease progression to decompensated cirrhosis & hepatocellular carcinoma (HCC, cancer) is on the same projectory increasing since 1992 through the end of the graph in 2006. (Figure 3)'

The combined use of a detailed disease progression model with backprojection methodology enables the estimation of fibrosis stage-specific incidence and prevalence of HCV disease states over time.
This is particularly useful when planning robust budget impact analyses, especially within the context of fibrosis stage-specific treatment response and response-guided therapy strategies
The number of incident HCV infections in England was estimated to peak in 1990 at approximately 20,702.
The cumulative number of patients in fibrosis stages F0 through F4 in 2009 was estimated to be 2,215, 24,092, 33,024, 65,097 and 124,428 respectively. Figure 2 shows the prevalence of HCV infection split by fibrosis stage.
Figure 3 contrasts observed versus predicted incidence of decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC) over the study period. Future projections of Hepatitis C-related complications estimate the number of incident cases of DCC, HCC and liver transplants between 2009 and 2015 to increase from 1,492 to 1,987 respectively.