Socioeconomic Deprivation Weighs Heavily on Liver Fibrosis and Mortality After Hepatitis C Cure (ANRS CO22 Hepather)

Although Hepatitis C virus (HCV) infection can be cured with direct-acting antivirals (DAA), some cured patients face a serious risk of advanced liver damage and early mortality. In order to avoid these two negative health outcomes, it is important to identify and assess related risk factors. Little is currently known about socioeconomic and behavioural factors in this context. Using data from the ANRS CO22 Hepather cohort, we tested for associations between socioeconomic and behavioural factors and (i) advanced liver fibrosis (defined as an FIB-4 > 3.25) assessed longitudinally using a mixed-effects logistic regression model (both the whole population and stratified on advanced liver fibrosis status at the time of HCV cure) and (ii) all-cause mortality (Cox proportional hazards model), during post-HCV cure follow-up. Among 5833 participants cured of HCV, living in poverty was associated with postcure advanced liver fibrosis in participants without this diagnosis at the time of HCV cure (population attributable fraction-PAF-of 8.6%) and with mortality in the whole study population (PAF of 10.6%). The detrimental effects of unhealthy alcohol use and heavy tobacco smoking, as well as the beneficial effect of living with a stable partner were also highlighted. We highlighted the major role of poverty and behavioural factors in advanced liver fibrosis and all-cause mortality in patients cured of HCV. Encouraging linkage to social support services and healthy behaviours after successful DAA treatment could limit morbidity and increase survival in this population. Clinical Trial Registration: ClinicalTrials.gov: NCT01953458.

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Publication Details

Journal
Journal of Viral Hepatitis
Published
2024-09-10
DOI
https://doi.org/10.1111/jvh.14006
Citations
1
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.39

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article

Socioeconomic Deprivation Weighs Heavily on Liver Fibrosis and Mortality After Hepatitis C Cure (ANRS CO22 Hepather)

Vincent Di Beo, Clémence Ramier, Marc Bourlière, Céline Dorival et al.
1 citations
Journal of Viral Hepatitis
Liver Disease Diagnosis and Treatment
0.39
article

Socioeconomic Deprivation Weighs Heavily on Liver Fibrosis and Mortality After Hepatitis C Cure (ANRS CO22 Hepather)

Vincent Di Beo, Clémence Ramier, Marc Bourlière, Céline Dorival, Dominique Larrey, Fabienne Marcellin, Cécile Moins, Camélia Protopopescu, Jessica Zucman‐Rossi, Jérôme Boursier, Lucia Parlati, Tangui Barré, Philippe Mathurin, Patrizia Carrieri, Jérôme Nicol, Fabrice Carrat
article en
1 citations

Abstract

Although Hepatitis C virus (HCV) infection can be cured with direct-acting antivirals (DAA), some cured patients face a serious risk of advanced liver damage and early mortality. In order to avoid these two negative health outcomes, it is important to identify and assess related risk factors. Little is currently known about socioeconomic and behavioural factors in this context. Using data from the ANRS CO22 Hepather cohort, we tested for associations between socioeconomic and behavioural factors and (i) advanced liver fibrosis (defined as an FIB-4 > 3.25) assessed longitudinally using a mixed-effects logistic regression model (both the whole population and stratified on advanced liver fibrosis status at the time of HCV cure) and (ii) all-cause mortality (Cox proportional hazards model), during post-HCV cure follow-up. Among 5833 participants cured of HCV, living in poverty was associated with postcure advanced liver fibrosis in participants without this diagnosis at the time of HCV cure (population attributable fraction-PAF-of 8.6%) and with mortality in the whole study population (PAF of 10.6%). The detrimental effects of unhealthy alcohol use and heavy tobacco smoking, as well as the beneficial effect of living with a stable partner were also highlighted. We highlighted the major role of poverty and behavioural factors in advanced liver fibrosis and all-cause mortality in patients cured of HCV. Encouraging linkage to social support services and healthy behaviours after successful DAA treatment could limit morbidity and increase survival in this population. Clinical Trial Registration: ClinicalTrials.gov: NCT01953458.

Journal of Viral HepatitisVol. 31(12)
Inserm (FR), Université Paris Cité (FR), Sorbonne Université (FR), Centre de Recherche des Cordeliers (FR), Hôpital Cochin (FR), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Européen Georges-Pompidou (FR), Hôpital Saint-Antoine (FR), Hôpital Européen (FR), Centre Hospitalier Universitaire d'Angers (FR), Agence Nationale de Recherches sur le Sida et les Hépatites Virales (FR), Hôpital Saint Joseph (FR), Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR), Hôpital Saint Eloi (FR), Economic & Social Sciences, Health Systems & Medical Informatics (FR), Institut de Recherche pour le Développement (FR), Université d'Angers (FR)
Bristol-Myers Squibb, Roche, Styrelsen för Internationellt Utvecklingssamarbete, Gilead Sciences, AbbVie, MSD France, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Association Française pour l'Etude du Foie, Cilag
No poverty
Openalex Percentile: Top 34%
Liver Disease Diagnosis and Treatment
0.39
DOIOpen Access PDFOpenAlex
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