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RISS 인기검색어
- 검색키워드
- 저자 : ( Yuichiro Eguchi ) (검색결과 3 건)
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( Zobair M. Younossi ),( Atsushi Tanaka ),( Yuichiro Eguchi ),( Linda Henry ),( Rachel Beckerman ),( Masashi Mizokami ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Japanese chronic hepatitis C (CHC) patients are at greater risk for hepatocellular carcinoma (HCC). Highly effective oral Direct Acting Antiviral (DAA) regimens for CHC can lead to high SVR rates that reduce CHC complications and costs. This study estimated the economic benefit of CHC cure by reducing HCC and decompensated cirrhosis (DCC) in Japan. Methods: A hypothetical cohort of 10,000 HCV GT1b Japanese patients with a mean age of 70 was modeled with a hybrid decision tree and Markov model capturing the natural history of HCV infection over a lifetime horizon. It was assumed that 15% of the cohort had cirrhosis and 20% were treatment-experienced. Treatment compared approved all-oral DAAs vs. no treatment (NT) with efficacy based on randomized controlled trials. Transition rates and costs were obtained from Japan-specific data. DCC, HCC and quality-adjusted life years (QALYs) were projected. QALYs were monetized using a willingness to pay (WTP) threshold which varied from ¥4 to ¥6 million. The incremental savings associated with treatment were calculated by adding the projected cost of complications avoided to the monetized gains in QALYs. Results: DAA treatment avoided 1583 cases of HCC and 1162 cases of DCC, saving ¥618,076 and ¥251,329 per treated patient; respectively. Treatment leads to avoidance of 2745 cases of CHC complications and associated savings of ¥869,405 per treated patient. Additionally, DAA treatment lead to an additional 1.59 QALYs gained per patient treated. The indirect economic gains associated with treatment-related QALY improvements were estimated to be ¥6,360,000, ¥7,950,000 and ¥9,540,000 per patient at WTP thresholds of ¥4 million, ¥5 million and ¥6 million. Total economic savings of HCV GT1 treatment with DAAs (vs. NT) was ¥7,229,405, ¥8,819,405and ¥10,409,405 at these different WTP thresholds. Conclusions: Treatment of HCV GT1b with all Oral DAAs in Japan can lead to significant savings related to avoidance of HCC and DCC.
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A Systematic Review of the Extrahepatic Manifestations of Hepatitis C Infection in East Asia
( Zobair M. Younossi ),( Linda Henry ),( Janus Ong ),( Atsushi Tanaka ),( Yuichiro Eguchi ),( Masashi Mizokami ),( Young-suk Lim ),( Yock Young Dan ),( Ming-lung Yu ),( Maria Stepanova ),( Sooji Lee ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Chronic hepatitis C (CHC) infection causes a systemic infection with hepatic and extrahepatic manifestation (EHMs). Although the prevalence of EHMs in Western countries is well described, the same is not well known in East Asian countries. We performed a systematic review to quantify the prevalence of selected EHMs among CHC patients in East Asia. Methods: PubMed, Medline, and Japan databases searched (1990-Dec 2016) with “hepatitis c virus” “chronic hepatitis C”, “extrahepatic manifestations”, and respective EHM’s. Data were collected and reviewed by two per PRISMA guidelines. EHMs were by ICD-9 codes or clinically: depression:BDI-2 score>19, chronic kidney disease (CKD): eGFR of < 60 mL/ min/1.73 m2 per MDRD, diabetes (DM):fasting blood glucose level > 126 mg/dL. Pooled prevalence determined by random effects models. Results: 75 articles were identified. After applying inclusion and exclusion criteria, 23 articles remained (Japan=6; China=3, Korea= 4, Taiwan=9, Asia=1) with a total of 468,656 subjects (n= 51,160 CHC and n= 417,496 non-HCV controls). HCV patient age ranged from 44-70 (mean age 55), 50% were male (range 0%-67%), and over 80% of diagnosis was established through positive HCV anti-body. CHC subjects had higher risk of lymphoma (n=2) 4.6% vs. 2.3%, OR=1.79 (1.47-2.19), P<0.0001; DM (n=11) 16.7% vs. 9.4%, OR=1.84 (1.52-2.21), P<0.0001; SS (n=2) 9.6% vs. 3.5%, OR=9.80 (1.25-76.56), P=0.0295; LP (n=5) 8.2% vs. 4.2%, OR=2.45 (1.36-4.41), P=0.0027; depression (n=1) 51.6% vs. 27.7%, OR=2.77 (1.25-6.15), P=0.0121; CKD (n=5) 3.8% vs. 1.7%, OR=2.00 (1.09-3.70), P=0.026; RA (n=2) 0.9% vs. 0.3%, OR=2.41 (1.54-3.76), P=0.0001; CVA (n=2) 25.3% vs. 19.3%, hazard ratio 1.38 (1.24-1.53), P<0.05; IHD (n=1) 25.3% vs 11.6%, OR=1.76 (1.04-2.96), P=0. 0.034. Additionally, the prevalence of MC (symptomatic and asymptomatic; n=1) in CHC was 46.9% in CHC vs. 1.9% in general population with a risk ratio of 24.7 (17.2-32.2). Conclusions: Our review found that CHC in East Asia is associated with increased risk for EHMs.
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