Future complications of chronic hepatitis C in a low-risk area: projections from the hepatitis c study in Northern Norway

• Main Authors: H. Kileng, L. Bernfort, T. Gutteberg, O.S. Moen, M.G. Kristiansen, E.J. Paulssen, L.K. Berg, J. Florholmen, R. Goll
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: Figshare 2017
• Subjects: Medicine; Biotechnology; 39999 Chemical Sciences not elsewhere classified; FOS Chemical sciences; Cancer; 110309 Infectious Diseases; FOS Health sciences; 60506 Virology; FOS Biological sciences; Computational Biology; Norway; Northern Norway
• Online Access: https://dx.doi.org/10.6084/m9.figshare.c.3881455.v1; https://figshare.com/collections/Future_complications_of_chronic_hepatitis_C_in_a_low-risk_area_projections_from_the_hepatitis_c_study_in_Northern_Norway/3881455/1

Abstract Background Hepatitis C (HCV) infection causes an asymptomatic chronic hepatitis in most affected individuals, which often remains undetected until cirrhosis and cirrhosis-related complications occur. Screening of high-risk subjects in Northern Norway has revealed a relatively low prevalence in the general population (0.24%). Despite this, late complications of HCV infection are increasing. Our object was to estimate the future prevalence and complications of chronic HCV infection in the period 2013â 2050 in a low-risk area. Methods We have entered available data into a prognostic Markov model to project future complications to HCV infection. Results The model extrapolates the prevalence in the present cohort of HCV-infected individuals, and assumes a stable low incidence in the projection period. We predict an almost three-fold increase in the incidence of cirrhosis (68 per 100,000), of decompensated cirrhosis (21 per 100,000) and of hepatocellular carcinoma (4 per 100,000) by 2050, as well as a six-fold increase in the cumulated number of deaths from HCV-related liver disease (170 per 100,000 inhabitants). All estimates are made assuming an unchanged treatment coverage of approximately 15%. The estimated numbers can be reduced by approximately 50% for cirrhosis, and by approximately one third for the other endpoints if treatment coverage is raised to 50%. Conclusion These projections from a low-prevalence area indicate a substantial rise in HCV-related morbidity and mortality in the coming years. The global HCV epidemic is of great concern and increased treatment coverage is necessary to reduce the burden of the disease.