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

• Published in: BMC Infectious Diseases
• Main Authors: Kileng, Hege, Bernfort, Lars, Gutteberg, Tore Jarl, Moen, Odd Sverre, Kristiansen, Magnhild Gangsøy, Paulssen, Eyvind Jakob, Berg, Leif Kyrre, Florholmen, Jon, Goll, Rasmus
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750; VDP::Medical disciplines: 700::Clinical medical disciplines: 750; Norway; Northern Norway
• Online Access: https://hdl.handle.net/10037/12170; https://doi.org/10.1186/s12879-017-2722-0

Source at: https://doi.org/10.1186/s12879-017-2722-0. © The Author(s). 2017 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.