Comorbidities and Prescribed Medications in Korean Patients with Chronic Hepatitis C: A Nationwide, Population-Based Study

• Published in: Gut and liver Vol. 15; no. 2; pp. 295 - 306
• Main Authors: Chung, Jung Wha, Choi, Hwa Young, Ki, Moran, Jang, Eun Sun, Jeong, Sook-Hyang
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 15.03.2021; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adolescent; Adult; Antiviral Agents - adverse effects; chronic; Comorbidity; drug interactions; drug therapy; Hepacivirus; hepatitis c; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - epidemiology; Humans; liver cirrhosis; Male; Middle Aged; Original; Republic of Korea - epidemiology; 내과학; Republic of Korea; Drug therapy; Hepatitis C; Comorbidity; Liver cirrhosis; chronic; Drug interactions
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl19387

Extrahepatic comorbidities and comedication are important to consider in the treatment of chronic hepatitis C (CHC) patients with direct-acting antivirals (DAAs) due to the risk of drug-drug interaction (DDI) and the effect of comorbidities on clinical outcomes. This study aimed to investigate the detailed profiles of comorbidities and comedication among Korean CHC patients. All adult patients (≥18 years old) with a primary diagnostic code of CHC in 2013 were selected from the National Health Insurance claims database. For each patient, all ICD-10 codes listed as primary or secondary diagnoses and all prescribed medications were collected. Among 47,104 CHC patients (median age, 57 years; male, 49.3%), 84.8% had at least one comorbidity for a mean number of 2.4, which increased with age. The most prevalent comorbidities were hypertension, esophagitis, dyslipidemia, diabetes mellitus, and peptic ulcer. Overall, 96.8% of the patients took at least one prescribed medication, with a mean of 8.1 medications/ year, and the three most common drug types were analgesics, gastrointestinal agents, and antibacterials. Use of at least one drug with a DDI risk category of "contraindicated medication" or "required dose-reduction/additional monitoring" was observed in 97% of the overall patients. The proportion of prescribed medications that were contraindicated with DAAs varied from 2.0% to 38.9% depending on the hepatitis C virus regimen. The majority of CHC patients had comorbidities; almost all patients took multiple prescribed medications, the number of which increased with age, and significant DDI risk was present in 97% of this Korean patient cohort. Comorbidities and comedication profiles should be considered during DAA therapy.