Hepatitis C in healthcare personnel: secondary data analysis of therapies with direct-acting antiviral agents
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RESEARCH
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Hepatitis C in healthcare personnel: secondary data analysis of therapies with direct-acting antiviral agents Claudia Westermann1* , Dana Wendeler2 and Albert Nienhaus1,2
Abstract Background: Hepatitis C Virus (HCV) infections are blood-borne, generally chronic and are associated with increased morbidity and mortality. The aim of this study is to describe the results of therapies with direct-acting antiviral agents (DAAs) in healthcare personnel. Methods: Secondary data analysis using data from the Statutory Accident Insurance of the Health and Welfare Service. The study surveyed DAA therapies administered to insured parties (healthcare personnel with an HCV infection recognised as an occupational disease) in Germany between 01/01/2014 and 30/11/2016. The end points were results of monitorings carried out twelve weeks after the end of treatment (SVR12), side effects and the results of the assessment of reduced work ability after treatment. Multivariate logistic regression models were constructed to model SVR12. Results: The study population (n = 180) comprised 74% women, 90% of the participants had an HCV genotype 1 infection. Two-thirds had fibrosis or cirrhosis and were treatment experienced. The most common combined therapy was ledipasvir and sofosbuvir (49%). A DAA therapy with ribavirin was administered in 20% of cases, with (pegylated) interferon and ribavirin used in 2% of cases. The majority of therapies were completed without any side effects. The overall SVR12 rate was 94%. Significant independent predictor of decrease odds of SVR12 was liver cirrhosis. Positive effects on the healthcare personnel’s work ability were observed after successful therapy. Conclusion: High SVR12 rates were achieved in the sample population, with positive effects on their work ability. Early HCV therapy seems reasonable due to the increased chance of successful treatment of the infection. Keywords: Hepatitis C virus, Occupational exposure, Blood-borne infections, Healthcare personnel, Direct-acting antiviral agents
Background The hepatitis C virus (HCV) is one of the most common infectious diseases in the world and develops into a chronic infection in up to 85% of cases. According to data from the World Health Organisation (WHO), approx. 71 million people globally have a chronic hepatitis C (CHC) infection [1, 2]. CHC is associated with higher morbidity and higher mortality [2, 3]. The use of direct-acting antiviral agents (DAAs) is currently leading * Correspondence: [email protected] 1 Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Martinistr. 52, 20146 Hamburg, Germany Full list of author information is available at the end of the article
to a major shift in the management of chronic HCV infections. DAAs open up the possibility for efficient oral therapy regimens with fewer side effects for patients with or without trea
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