Modelling the past, current and future HCV burden in France: detailed analysis and perspectives

Two national HCV projections have been published in France which assumed that a part of observed hepatocellular carcinoma (HCC) deaths is a consequence of HCV epidemic. They applied the back-calculation method, in combination with a Markov model, to reconstruct the past history of HCV infection and then to predict HCV-related mortality. A preliminary model was first developed in the absence of effective therapy. It allowed testing many assumptions to model HCV natural history that were compatible with observed incidence of HCV-related HCC deaths. This model was then updated to take into account the availability of treatment and more recent epidemiological data. These two models are described in detail and results are discussed with a view to addressing the models' limitations. The models offered a useful tool to assess public health policy scenarios in planning healthcare responses to the HCV epidemic.