{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:07:45Z","timestamp":1789193265850,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Since the inception of the interferon\u2010free direct\u2010acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection, guidelines as to who should receive this potentially curative treatment have evolved. Treatment with DAAs is now considered for all patients except for those considered moribund.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the DAA treatment rate for patients with HCV\u2010related hepatocellular carcinoma (HCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study from January 2015 to March 2021 of a national sample of privately insured patients with HCV\u2010related HCC using Optum's Clinformatics\u00ae Data Mart (CDM) Database \u2013 a large, de\u2010identified, adjudicated claims database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 3922 patients with HCV\u2010related HCC: 922 (23.5%) received DAA. Compared to untreated patients, DAA\u2010treated patients were younger (65.2\u2009\u00b1\u20097.5 vs. 66.4\u2009\u00b1\u20097.5\u2009years, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), more frequently saw a gastroenterology\/infectious disease (GI\/ID) physician (41.2% vs. 34.2%), and had decompensated cirrhosis (56% vs. 53%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). In multivariable analysis, younger age (HR: 0.98, 95% CI: 0.97\u20130.99, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), GI\/ID care (HR: 3.06, 95% CI: 2.13\u20134.51, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and having cirrhosis (compensated: HR: 1.60, 95% CI: 1.18\u20132.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.003; decompensated: HR: 1.45, 95% CI: 1.07\u20131.98, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were associated with receiving DAA treatment, but not sex, race, or ethnicity. DAA\u2010treated patients had significantly higher 5\u2010year survival than untreated patients (47.2% vs. 35.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Following adjustment for age, sex, race\/ethnicity, Charlson Comorbidity Index, and HCC treatment, receiving DAA treatment was associated with lower mortality (aHR: 0.61, 95% CI: 0.53\u20130.69, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DAA treatment remains underutilised in insured patients with HCV\u2010related HCC; fewer than one in four patients received treatment. Seeing a specialist and having decompensated cirrhosis were predictors for DAA treatment; additional efforts are needed to increase awareness of HCV treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17794","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T10:17:16Z","timestamp":1699438636000},"page":"350-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Treatment rates and factors associated with direct\u2010acting antiviral therapy for insured patients with hepatitis C\u2010related hepatocellular carcinoma \u2013 A real\u2010world nationwide study"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0469-4543","authenticated-orcid":false,"given":"Leslie Y.","family":"Kam","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-5954","authenticated-orcid":false,"given":"Yee Hui","family":"Yeo","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1463-8035","authenticated-orcid":false,"given":"Fanpu","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Second Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Henry","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsey","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto California USA"},{"name":"Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Health Care System  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-4989","authenticated-orcid":false,"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto California USA"},{"name":"Department of Epidemiology and Population Health Stanford University Medical Center  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-10-200605160-00004"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30181-9"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000218339"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30579-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx030"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40164-018-0109-6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.02.027"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2575"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.08.030"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.10.029"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000755"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14685"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.04.017"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.5699"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30988"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.07.040"},{"key":"e_1_2_9_18_1","unstructured":"Stanford Center for Population Health Sciences(2021).Optum DOD (v5.0). 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