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

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...

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Bibliographic Details
Published in:BMC Infectious Diseases
Main Authors: Kileng, H., Bernfort, Lars, Gutteberg, T., Moen, O. S., Kristiansen, M. G., Paulssen, E. J., Berg, L. K., Florholmen, J., Goll, R.
Format: Article in Journal/Newspaper
Language:English
Published: Linköpings universitet, Avdelningen för hälso- och sjukvårdsanalys 2017
Subjects:
Disease burden
Fibrosis development
Hepatitis C
Markov modelling
Natural course
Infectious Medicine
Infektionsmedicin
Norway
Northern Norway
Online Access:http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-141713
https://doi.org/10.1186/s12879-017-2722-0
Description
Summary: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 2013-2050 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.

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