2013-2022年日本引入直接作用抗病毒药物后丙型肝炎医疗负担趋势：日本国家索赔数据库研究

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-09-02 DOI:10.1016/j.ijid.2025.108043

Shimpei Yamashita , Naoki Kanda , Hideki Hashimoto , Hiromasa Yoshimoto , Kazuo Goda , Naohiro Mitsutake , Shuji Hatakeyama

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引用次数: 0

摘要

目的：描述引入无干扰素直接作用抗病毒药物（DAAs）后慢性丙型肝炎、肝细胞癌（HCC）发病率和相关医疗负担的趋势。方法：这项重复的横断面研究（时间趋势分析）检查了慢性丙型肝炎和相关的医疗保健，包括HCC，使用的是2013 - 2022财政年度日本医疗保健服务的国家索赔数据。结果：在研究期间，357,877例患者接受了DAAs治疗。接受慢性丙型肝炎治疗的个人患病率下降了40%(95%可信区间[CI]: 40%-40%)，从2013年的0.54%降至2022年的0.33%。在艾滋病毒感染者中，下降幅度较小，为16% (95% CI: 10%-20%)，到2022年患病率为3.82%。新诊断HCC的年发病率下降了69% (95% CI: 68%-70%)，同时HCC治疗减少。慢性丙型肝炎患者的年度医疗费用在2015年达到峰值，到2022年降至2013年水平的65%。结论：在10年DAA期间，日本丙型肝炎的医疗负担大幅下降。加强预防、筛查和治疗工作对于根除丙型肝炎至关重要，特别是在高危人群，如艾滋病毒感染者中。

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Trends in the healthcare burden of hepatitis C after the introduction of direct-acting antivirals in Japan, 2013-2022: A national claims database study in Japan

Objectives

To describe trends in the incidences of chronic hepatitis C, hepatocellular carcinoma (HCC), and related healthcare burden after the introduction of interferon-free direct-acting antivirals (DAAs).

Methods

This repeated cross-sectional study (time trend analysis) examined chronic hepatitis C and related healthcare, including HCC, using national claims data covering >98% of healthcare services in Japan between fiscal years 2013 and 2022.

Results

During the study period, 357,877 patients were treated with DAAs. The prevalence of individuals receiving care for chronic hepatitis C decreased by 40% (95% confidence interval [CI]: 40-40%), from 0.54% in 2013 to 0.33% in 2022. Among individuals with HIV, the reduction was smaller, at 16% (95% CI: 10-20%), with a prevalence of 3.82% in 2022. The annual incidence of newly diagnosed HCC decreased by 69% (95% CI: 68-70%), accompanied by a reduction in HCC treatments. Annual healthcare costs for individuals with chronic hepatitis C peaked in 2015 and decreased to 65% of 2013 levels by 2022.

Conclusion

During the 10-y DAA era, the healthcare burden of hepatitis C declined substantially in Japan. Enhanced efforts in prevention, screening, and treatment are critical for the eradication of hepatitis C, particularly among high-risk populations, such as individuals with HIV.

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.