HCV Complications Increasing for Women Veterans

HOUSTON—The epidemiology clinical course of hepatitis C virus (HCV) infection is affected by gender. Yet, few long-term longitudinal studies have examined trends in the incidence and prevalence of serious liver complications among women compared with men with HCV infection, according to a new study published in the Journal of Viral Hepatitis.1

Michael E. DeBakey VAMC-led researchers used the Veterans Administration Corporate Data Warehouse to identify all veterans with positive HCV viraemia from January 2000 to December 2013. The study team then calculated gender-specific annual incidence and prevalence rates of cirrhosis, decompensated cirrhosis and hepatocellular cancer (HCC), while adjusting for age, diabetes, HIV and alcohol use.

Also calculated was the average annual percent change (AAPC) for each outcome by gender.

The focus was on 264,409 HCV-infected veterans during 2000-2013, of whom 2.7% were women. Statistically significant increases occurred over time in the incidence rates of cirrhosis, decompensated cirrhosis and HCC for both men and women.

Results indicated that the annual-adjusted incidence rates of cirrhosis, decompensated cirrhosis and HCC were higher in men than women for all study years. Complications increased at a similar rate in both groups, however.

The study revealed that the AAPC for cirrhosis was 13.1 and 15.2; 15.6 and 16.9 for decompensated cirrhosis and 21.0 and 25.3 for HCC in men and women, respectively. Results were similar in the prevalence analyses, although AAPCs were slightly smaller for each outcome, the study authors noted.

“In conclusion, we found an ongoing upward trend in the incidence and prevalence of HCV complications in this cohort of HCV-infected women,” the researchers wrote. “This increase in cirrhosis complications in women with active HCV infection is similar to those in men. With cure from HCV now becoming a reality, most of the projected burden of HCV is potentially preventable. However, benefits of HCV treatment will need to extend to all patients in order to stem the rising tide of HCV complications.”

1.Kramer JR, El-Serag HB, Taylor TJ, White DL, et. al. Hepatitis C virus-related complications are increasing in women veterans: A national cohort study. J Viral Hepat. 2017 Nov;24(11):955-965. doi: 10.1111/jvh.12728. Epub 2017 Aug 16. PubMed PMID: 28815822; PubMed Central PMCID: PMC5638671.

AIDS. 2017 Sep 24;31(15):2095-2106. doi: 10.1097/QAD.0000000000001594.

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