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Understanding hepatitis C

John G McHutchison1

  • 1Gastroenterology and Hepatology Research, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.

The American Journal of Managed Care
|April 16, 2004
PubMed

Insights

Hepatitis C virus (HCV) affects millions globally, causing significant deaths and liver transplants in the US. Long-term infections acquired decades ago will increase future disease burden and healthcare costs.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Hepatitis C virus (HCV) infection impacts 4 million in the US and 170 million worldwide.
  • HCV causes 10,000 annual deaths and is the leading cause of liver transplantation in the US.
  • New HCV infections primarily stem from injection drug use (68%) and sexual transmission (18%).

Purpose of the Study:

  • To review the virology, serology, epidemiology, and natural history of HCV.
  • To analyze the current and projected future disease burden of HCV in the United States.
  • To highlight implications for clinicians and pharmacists in managed care settings.

Main Methods:

  • Review of existing literature on HCV.
  • Analysis of epidemiological data and disease trends.
  • Projection of future morbidity, mortality, and costs associated with HCV.

Main Results:

  • HCV prevalence is 1.8% in the US, with many unaware of their infection.
  • Despite a decline in new infections since the 1990s, long-term infections from the 1960s-1980s will increase future disease burden.
  • A proportion of long-term HCV patients will develop cirrhosis, decompensated liver disease, or hepatocellular carcinoma (HCC).

Conclusions:

  • The aging cohort of HCV-infected individuals poses a significant future challenge.
  • Increased rates of cirrhosis, decompensated liver disease, and HCC are anticipated.
  • Managed care settings must prepare for rising HCV-related end-stage liver disease and HCC cases.

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