Author:
Sagmeister M, Eur J Gastroenterol Hepatol 2002 Jan
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Date Posted: Sat, January 19 2002, 9:43:24 PST
In reply to:
Barrett S, Goh J et al Gut 2001 Sep;49(3):423-30
's message, "The natural course of hepatitis C virus infection after 22 years" on Fri, August 24 2001, 15:49:40 PDT
Eur J Gastroenterol Hepatol 2002 Jan;14(1):25-34
Sagmeister M, Renner EL, Mullhaupt B, Wong JB.
Division of Gastroenterology and Hepatology, University Hospital, Zurich, Switzerland; and bDivision of Clinical Decision Making, Informatics and Telemedicine, Department of Medicine, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
OBJECTIVE : Hepatitis C is a major cause of liver disease in European countries. We aimed to assess the current and future disease burden of hepatitis C.
SETTING : A representative data set of hepatitis C was applied to a validated computer model.
METHODS : The mandatory reporting of positive hepatitis C virus (HCV) test results by all medical laboratories in Switzerland and the clinical data obtained by questionnaire for each positive test from the treating physicians created a unique, representative epidemiological database allowing the determination of the age distribution of acute (i.e. newly acquired) and chronic HCV infections. Based on these data and a simulation model of the natural history of hepatitis C, we estimated the prevalence of HCV infection, future morbidity/mortality from cirrhosis/hepatocellular carcinoma and costs.
RESULTS : Our analysis estimates a prevalence of anti-HCV in Switzerland of 1.25-1.75%, which is slightly higher than prior reports (0.5-1%) derived by extrapolation from selected populations. Although new HCV infections decreased after 1990, our analysis predicts that HCV-related morbidity and mortality will increase by 70-90%, reaching a maximum in 2015-2020, largely from complications in cases already prevalent in 1998. The model predicts that the incidence of cirrhosis will begin to decrease after 2005-2010. Antiviral treatment reduces disease burden by approximately 5%. Undiscounted HCV-related annual direct costs will more than double and reach a maximum of almost US$33 million in 2020.
CONCLUSIONS : The incidence of HCV-related cirrhosis is predicted to decrease after 2005-2010, while disease burden and costs due to complications are estimated to continue to increase until 2015-2020.
PMID: 11782572 [PubMed
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