Chronic hepatitis C: Treat or wait? Medical decision making in clinical practice

Table 1 Demographic data and basic characteristics

Characteristics	Not treated (n = 7658)	Treated (n = 6341)
% of the 13 999 patients	55.7	45.3
Genotypes 1/4/5/6 (%)	69.8	59.4
Genotypes 2/3 (%)	30.2	40.6
Age (yr, median)	44.0	41.0
BMI (kg/m2, median)	24.2	24.3
Gender (male %)	56.6	61.1
Regulär employment (%)	35.3	50.2
Infection length (yr, median)	11.0	10.0
Ultrasound performed (%)	76.8	87.6
Liver biopsy performed (%)	12.8	30.2
Fibrosis score F 0-1	72.8	58.6
Fibrosis score F 2-4	27.2	41.4
Active drug or alcohol abuse (%)	28.3	13.8
HIV co-infection (%)	6.7	3.7
Psychiatric disease (%)	14.8	9.2
Severe language problems (%)	9.6	10.0
Initial HCV-RNA (IU/mL, median)	482 500	500 000
ALT (U/L, median)	61.0	78.0
Thrombocytes (/μL, median)	217 000	218 000
At least on concomitant disease (%)	62.3	42.6

BMI: Body mass index; HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; ALT: Alanine aminotransferase.

Table 2 Treatment and sustained virological response rates in various subgroups

				Fischer’s exact test, two-sides P value
	Treatment rate %	SVR %	Number	Treatment rate	SVR
Total	45.3	49.6	13 999
Genotypes 1/4/5/6	41.4	42.7	9114	< 0.0001	< 0.0001
Genotypes 2/3	52.7	59.8	4885
Clinical setting	63.9	49.8	1298	< 0.0001	NS
Private practice	43.4	49.6	12 701
Male	47.2	47.9	8214	< 0.0001	< 0.01
Female	42.6	52.3	5785
Age ≤ 56 yr	49	51.3	11 497	< 0.0001	< 0.0001
Age > 56 yr	28.2	36.7	2502
BMI ≤ 23 (kg/m2)	44.3	51.8	4762	< 0.01	< 0.05
BMI > 23 (kg/m2)	46.9	48.6	8846
No employment	38.9	47.3	8113	< 0.0001	< 0.001
Regular employment	54.1	52	5886
Bad German language skills	47	52.5	824	NS	NS
Good German language skills	45.8	47.8	7565
Migrants	53.3	52.6	2663	< 0.0001	< 0.0001
German natives	41.7	45.4	5465
Infection length ≤ 12.5 yr	62.8	51.6	3639	< 0.0001	< 0.01
Infection length > 12.5 yr	37.2	48	3165
Ultrasound not performed	30.7	47.5	2568	< 0.0001	NS
Ultrasound performed	48.6	50	11 431
Liver biopsy not performed	39.9	50.1	11 100	< 0.0001	NS
Liver biopsy performed	66.1	48.5	2899
Fibrosis scores F0-1	60.9	52.4	1766	< 0.0001	< 0.01
Fibrosis scores F2-4	74.6	44.1	1017
Clinical symptoms absent	42.2	47.8	4430	< 0.0001	NS
Clinical symptoms present	46.7	50.4	9569
No concomitant disease	55.7	51.8	6527	< 0.0001	< 0.0001
At least one concomitant disease	36.2	46.8	7472
Psychiatric disease absent	46.9	49.8	12 281	< 0.0001	NS
Psychiatric disease present	34.1	48.4	864
Active drug or alcohol abuse absent	49.9	49.7	10 960	< 0.0001	NS
Active drug or alcohol abuse present	28.7	49.4	3039
HIV co-infection absent	46.1	50	13 254	< 0.0001	< 0.01
HIV co-infection present	31.4	39.3	745
Good quality-of-life	43.8	49.5	11 348	< 0.0001	NS
Reduced quality-of-life	51.8	50.1	2651
ALT normal (< 50 U/L for men, < 30 U/L for women)	34.8	50.8	3297	< 0.0001	NS
ALT elevated (U/L)	49.6	49.7	10 105
Thrombocytes ≥ 142 500 /μL	48	51.6	11 284	< 0.0001	< 0.0001
Thrombocytes < 142 500 /μL	38.9	36.2	1816
HCV-RNA ≤ 520 000 IU/mL	45.4	54.8	6810	< 0.0001	< 0.0001
HCV-RNA > 520 000 IU/mL	49.7	43.3	5904
No concomitant disease	55.7	51.8	6527	< 0.0001	< 0.0001
At least one concomitant disease	36.2	46.8	7472
HIV co-infection absent	46.1	50	13 254	< 0.0001	< 0.01
HIV co-infection present	31.4	39.3	745

SVR: Sustained virological response; BMI: Body mass index; HIV: Human immunodeficiency virus; ALT: Alanine aminotransferase; HCV: Hepatitis C virus; NS: Not significant.

Table 3 Treatment and sustained virological response rates vs socio-economic problems and concomitant diseases

Characteristics	Treatment rate %	SVR %	n
Drug abuse absent and employed without psychiatric disease or HIV co-infection	58.2	52.7	4382
Drug abuse absent and employed without psychiatric disease	58.2	52.4	4560
Drug abuse absent and employed	57.1	52.6	4929
Drug abuse absent	49.2	49.6	10 839
Drug abuse present	32.0	49.9	3160
Drug abuse present and unemployed	29.1	51.6	2203
Drug abuse present and unemployed with psychiatric disease	25.1	50.8	470
Drug abuse present and employed with psychiatric disease and HIV co-infection	7.1	0.0	56

HIV: Human immunodeficiency virus.