Background: At present, reimbursement of interferon-free all-oral regimens for chronic hepatitis
C in Austria is limited to patients with advanced liver fibrosis. The aim of this
study was to assess the distribution of stages of fibrosis and hence, access to interferon-free
regimens in patients presenting at our outpatient clinic.
Patients and Methods: A total of 257 consecutive patients [m/f: 161/96, mean age: 51 ± 11 years, GT 1:
11 (4.3%), GT 1a: 60 (23.3%), GT 1b: 59 (23.0%), GT2: 5 (1.9%), GT 3: 42 (16.3%),
GT 4: 21 (8.2%), GT not yet available: 59 (23.0%)] who presented at our outpatient
clinic between 26.09.2014 and 3.3.2015 were included in this analysis. Fibroscan®
was performed in all patients using the Fibroscan® 502 Touch device with the M-probe.
Cut off values for liver stiffness (LS) assessment were defined as 7.1 kPa for F ≥2,
9.5 kPa for F≥3 and 12.5 kPa for F = 4. A valid LS measurement was defined as 10 successful
measurements with an interquartile range < 30%.
Results: LS values varied between 2.8 and 75.0 kPa. Valid measurements were obtained in 201/257
(78.2%) patients. F0/F1, F2 and F3 were found in 89 (44.3%), 34 (16.9%) and 26 (12.9%)
patients, respectively. 52 (25.9%) patients had cirrhosis [Child A: 43 (82.7%), Child
B: 4 (7.7%), Child C: 1 (1.9), NA: 4 (7.7%)]. Therefore, Fibroscan® revealed evidence
for either bridging fibrosis or cirrhosis in 78/257 (30.4%) patients. In addition,
29/56 (51.8%) patients in whom no valid Fibroscan® result could be obtained, were
diagnosed to have liver cirrhosis based on clinical and radiological findings and
laboratory results. In three patients with fibrosis stage <F3, an interferon-free,
all-oral treatment was nonetheless reimbursed due to severe extrahepatic manifestations.
Conclusion: Given current reimbursement criteria in Austria, 110/257 (42.8%) of our patients
were granted access to all-oral interferon-free therapy.
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