Chronic liver disease is characterized by progressive destruction of the liver, eventually resulting in liver failure, making transplant necessary.
The most common types of chronic liver disease relate to hepatitis virus (A-E, with different disease rates), cirrhosis, and non-alcoholic fatty liver disease (NAFLD). CDRG’s expertise includes study design and analysis of administrative claims data (Medicare, MarketScan), and our study areas include epidemiology of NAFLD and non-alcoholic steatohepatitis (NASH), disease progression from NASH to end-stage liver disease (ESLD), health care utilization and costs for patients with NASH and ESLD, and treatment and outcomes for chronic hepatitis.
According to the Centers for Disease Control and Prevention (CDC), cases of acute hepatitis C virus infection increased more than 2.5 times from 2010 to 2014, and approximately 3.5 million Americans are currently infected. Viral hepatitis is caused by infection with any of at least five distinct viruses, hepatitis A B, C, D, and E. Most viral hepatitis infections in the US is attributable to A, B, and C. All three of these unrelated viruses can produce an acute illness, although many acute infections are asymptomatic or cause only mild disease. Many people infected with hepatitis B or C are unaware of the infection and carry it for decades until they develop cirrhosis, ESLD, or hepatocellular carcinoma.
Liver cirrhosis, a progressive disease in which healthy liver tissue is replaced by scar tissue (fibrosis), occurs most often due to alcohol abuse or hepatitis B or hepatitis C infection. In 2014, liver cirrhosis accounted for over 38,000 deaths, according to the CDC. Treatment of cirrhosis intends to slow the progression of fibrosis and control the cause (e.g., alcohol dependency) or comorbid conditions, but no cure exists.
NAFLD is characterized by too much fat stored in liver cells. Disease progression is marked by liver inflammation, scarring, and irreversible damage, culminating in cirrhosis and liver failure. NAFLD occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease, due to risk factors such as obesity and type 2 diabetes. Recent research found that bone and skeletal muscle disorders appeared to be independently associated with NAFLD. NASH is a more severe form of fatty liver disease.
Given the current state of knowledge, and our background in this area, we are excited to be at the forefront of this growing field, with the opportunity to make a long-lasting difference in patients' lives. Let us know how we can assist you with your next project.
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