Early treatment of chronic hepatitis C may mean liver biopsies no longer necessary

News release from the National Coordinating Centre for Health Technology Assessment

27 June 2006

New research commissioned by the NIHR Health Technology Assessment (HTA) programme suggests that combination anti viral therapy for treatment of chronic hepatitis C at a mild rather than a moderate stage is clinically and cost-effective for most patients. However the research also suggests that, for patients aged 65 or over who have genotype 1 of the virus, early treatment is not cost-effective. Contrary to current practice, the findings indicate that invasive liver biopsy tests may no longer be necessary before treatment for most patients.

Recent reports by the Health Protection Agency have identified hepatitis C infection as a growing public health concern, with fears that the number of people suffering from hepatitis C related illnesses could double by 2010.

The £1.2 million multi-centre trial, carried out by a research team from Imperial College London, headed up by Professor Howard Thomas, monitored more than 200 patients over 48 weeks. It compared patients who had been treated with combined interferon alpha and ribavirin with a group of patients who received no treatment, analysing factors such as sustained clearance of the virus, progression of liver disease, and the quality of life of patients, to establish whether combined therapy at a mild stage is more clinically and cost-effective than no treatment. The trial also used analysis models to assess the lifetime cost-effectiveness of the intervention.

The research team concluded that early treatment for mild chronic hepatitis C is effective and cost-effective for most patients, and would probably be considered so by NHS policy makers at the £30,000 per QALY threshold.

“There are concerns that within the next few years hepatitis C could reach epidemic proportions, so it is vital that the best methods for treating the disease are investigated,” says Professor Thomas. “The findings of the study suggest that systems should be developed to ensure that early therapy is offered to most patients, and that liver biopsy before treatment may no longer be necessary for most patients apart from those aged over 65 who have genotype 1 hepatitis C and wish to be evaluated for treatment.”

The research published in Health Technology Assessment Vol 10 no. 21, to download a copy of the full report please visit the HTA website www.hta.ac.uk/project/1089.asp

Notes:

  1. Hepatitis C infects up to 30% of injecting drug users and 0.7% of the general population in the UK (according to Department of Health statistics)

Notes for editors


  1. The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with more than 400 issues published to date. The journal’s 2007 Impact Factor (3.87) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.
  2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility.  The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training.  Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk

Contact details

Naomi Stockley, Programme Manager (Communications)
Telephone: 02380 595 646, Email: ns5@soton.ac.uk

Helen Nikandrou, Assistant Programme Manager (Communications)
Telephone: 02380 595 584, Email: h.nikandrou@soton.ac.uk

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