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Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment

Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment
Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment

OBJECTIVES: To estimate hepatitis C virus (HCV) progression rates between disease stages prior to cirrhosis, using data from liver biopsies in three observational cohorts. To demonstrate how the method of cohort recruitment can influence the estimation of HCV-progression rates.

STUDY DESIGN AND SETTING: Data came from three United Kingdom observational cohorts, assembled from different referral sources. In total, 987 HCV-infected patients with an estimated (or known) date of infection and at least one histologically scored liver biopsy were eligible for inclusion in the analysis. Liver biopsy scores were used to determine the stage of HCV-related liver disease. A three-state continuous time Markov model was used to estimate covariate-specific average probabilities of progression of disease.

RESULTS: After adjusting for confounders, considerably different rates of disease progression were estimated in the three cohorts. For a group of patients with the same demographics, the estimated 20-year probability of progression to cirrhosis was 12% (95% confidence interval CI = 6-22) in a hospital-based cohort, 6% (95% CI = 3-13) in a posttransfusion cohort, and 23% (95% CI = 14-37) in a cohort recruited from a tertiary referral center.

CONCLUSION: Researchers using estimates of disease progression should be aware that the method of cohort recruitment has considerable influence on the progression rates that are derived.

Cohort Studies, Disease Progression, Hepatitis C/pathology, Humans, Liver/pathology, Liver Cirrhosis/pathology, Markov Chains, Patient Selection, Probability, United Kingdom
0895-4356
144-52
Sweeting, Michael J
00a91fae-1103-4ebc-a195-575f892d0034
De Angelis, Daniela
1c423ede-4497-4615-8545-d8528a6067af
Neal, Keith R
8a811231-3890-485e-b6c9-373cc10bb917
Ramsay, Mary E
300493c6-9c09-49b3-945a-4bca07a6f65d
Irving, William L
ed6993df-07a9-4cc1-a859-aa616d644f43
Wright, Mark
43325ef9-3459-4c75-b3bf-cf8d8dac2a21
Brant, Lisa
11b4fac6-c153-40f8-9ea3-af20c69580b4
Harris, Helen E
9300b296-c563-4454-8f2e-a292f1b9dbaf
Trent HCV Study Group
Sweeting, Michael J
00a91fae-1103-4ebc-a195-575f892d0034
De Angelis, Daniela
1c423ede-4497-4615-8545-d8528a6067af
Neal, Keith R
8a811231-3890-485e-b6c9-373cc10bb917
Ramsay, Mary E
300493c6-9c09-49b3-945a-4bca07a6f65d
Irving, William L
ed6993df-07a9-4cc1-a859-aa616d644f43
Wright, Mark
43325ef9-3459-4c75-b3bf-cf8d8dac2a21
Brant, Lisa
11b4fac6-c153-40f8-9ea3-af20c69580b4
Harris, Helen E
9300b296-c563-4454-8f2e-a292f1b9dbaf

Trent HCV Study Group (2006) Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment. Journal of Clinical Epidemiology, 59 (2), 144-52. (doi:10.1016/j.jclinepi.2005.06.008).

Record type: Article

Abstract

OBJECTIVES: To estimate hepatitis C virus (HCV) progression rates between disease stages prior to cirrhosis, using data from liver biopsies in three observational cohorts. To demonstrate how the method of cohort recruitment can influence the estimation of HCV-progression rates.

STUDY DESIGN AND SETTING: Data came from three United Kingdom observational cohorts, assembled from different referral sources. In total, 987 HCV-infected patients with an estimated (or known) date of infection and at least one histologically scored liver biopsy were eligible for inclusion in the analysis. Liver biopsy scores were used to determine the stage of HCV-related liver disease. A three-state continuous time Markov model was used to estimate covariate-specific average probabilities of progression of disease.

RESULTS: After adjusting for confounders, considerably different rates of disease progression were estimated in the three cohorts. For a group of patients with the same demographics, the estimated 20-year probability of progression to cirrhosis was 12% (95% confidence interval CI = 6-22) in a hospital-based cohort, 6% (95% CI = 3-13) in a posttransfusion cohort, and 23% (95% CI = 14-37) in a cohort recruited from a tertiary referral center.

CONCLUSION: Researchers using estimates of disease progression should be aware that the method of cohort recruitment has considerable influence on the progression rates that are derived.

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More information

Published date: 1 February 2006
Keywords: Cohort Studies, Disease Progression, Hepatitis C/pathology, Humans, Liver/pathology, Liver Cirrhosis/pathology, Markov Chains, Patient Selection, Probability, United Kingdom

Identifiers

Local EPrints ID: 478079
URI: http://eprints.soton.ac.uk/id/eprint/478079
ISSN: 0895-4356
PURE UUID: a3b6b852-e5b7-46b6-b534-6101001b7967

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Date deposited: 21 Jun 2023 16:53
Last modified: 17 Mar 2024 02:14

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Contributors

Author: Michael J Sweeting
Author: Daniela De Angelis
Author: Keith R Neal
Author: Mary E Ramsay
Author: William L Irving
Author: Mark Wright
Author: Lisa Brant
Author: Helen E Harris
Corporate Author: Trent HCV Study Group

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