The analysis will be conducted among US veterans, aged 18 years or older, with chronic HCV who sought care at any of the medical centers and ambulatory care and community-based outpatient clinics that comprise the national VA healthcare system. This analysis will be restricted to HCV mono-infected (i.e., no hepatitis B virus or human immunodeficiency virus coinfection) patients with compensated liver cirrhosis.
Inclusion criteria:
1. Patients with chronic HCV defined as a positive test for HCV ribonucleic acid (RNA) in plasma by qualitative or quantitative assays or genotype test between January 01, 2005 and December 31, 2017.
2. For the first primary objective (DAA only treated and untreated patients): a clinical encounter (i.e., office visit, procedure, lab result, prescription, etc.) recorded in the 6 months preceding and including January 01, 2013 or between January 01, 2013 and December 31, 2017.
3. For the second primary objective: for IFN treated patients, the IFN based treatment was initiated after the above HCV diagnosis, but between January 01, 2005 and December 31, 2013. If DAA-only exposed, the DAA treatment was initiated after the above HCV diagnosis, but between January 01, 2014 and December 31, 2017.
4. Patients with data in VA sources to establish a diagnosis of compensated cirrhosis as follows: • At least 1 fibrosis-4 (FIB-4) > 3.25 within 24 months before or 6 months after the index date but before any HCV treatment (and with all measurements for FIB-4 calculation within 6 months of each other) or at least 1 ICD-9 (571.2, 571.5) or ICD-10 (K70.30, K70.31, K74.60, K74.69, K74.3, K74.4 and K74.5) code indicating cirrhosis, and • No diagnosis codes for hepatic decompensation defined as ascites, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, or hepatorenal syndrome based on inpatient or outpatient ICD-9 codes of 789.5, 456.0–2, 572.4, 572.2, 348.3×, 070.0, 070.2×, 070.4×, 070.6, 070.71, or corresponding ICD-10 codes d