The burden of hepatitis C in the United States

Kim, Woojin

doi:10.1053/jhep.2002.36791

Cited by 274 publications

(175 citation statements)

References 16 publications

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“…In general, cause-specific mortality is reflected poorly in death certificate data. Consistent with some authors' suggestions, 26,27 future analyses of CLD mortality and its causes should include viral hepatitis and sequelae of CLD deaths because of the narrow definition of CLD in ICD. Further studies are needed to evaluate the validity of estimates of the mortality burden from CLD generated from national mortality data and to characterize better the causes of CLD deaths.…”

Section: Discussionmentioning

confidence: 59%

Chronic liver disease mortality in the United States, 1990-1998

2004

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In 1998, chronic liver disease (CLD) was the tenth leading cause of death in the U.S. Alcohol and hepatitis C are thought to be important etiologies. However, traditional methods for calculating CLD mortality rates from death certificates may underestimate hepatitis Crelated CLD mortality. We studied patterns of CLD deaths reported from 1990 through 1998, using an expanded definition that included death certificates where CLD, viral hepatitis, or CLD-related sequelae were reported as the underlying cause. We calculated overall age-specific and age-adjusted mortality rates, and according to demographic characteristics and recorded causes, and evaluated trends using linear regression modeling. CLD mortality declined 5% overall from 1990 through 1994 (12.1 to 11.6/100,000; P ‫؍‬ 0.002), but remained unchanged from 1995 through 1998 (P ‫؍‬ 0.366). Decreases were similar for all causes except hepatitis C, for which rates increased 220% from 1993 to 1998 (0.57 to 1.67/100,000). Rates declined in all racial-ethnic groups except American Indians and Alaska Natives (AI/AN), among whom rates were unchanged. Of 30,933 CLD deaths in 1998, 39% were coded as alcohol related, 15% as hepatitis C, 4% as hepatitis B, and 44% had no recorded cause. Age-adjusted rates were higher among males (47.6/100,000) than females (32.2/100,000) and among Hispanics (19.1/100,000) compared with non-Hispanics (10.8/ 100,000). Rates among AI/AN (28.7/100,000) were more than twice those of African Americans and whites (12.9/100,000 and 11.5/100,000, respectively). In conclusion, 1998 CLD deaths and the proportion attributable to viral hepatitis increased by 23% and 19%, respectively, compared with traditional methods. Mortality declines of the early 1990s were not sustained after 1994. Large disparities in CLD mortality remain, particularly among Amer-

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Section: Discussionmentioning

confidence: 59%

Chronic liver disease mortality in the United States, 1990-1998

2004

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“…Overall, the total economic impact of the disease in the United States is between $1 and $1.3 billion per year and is considerably more worldwide. 5,6 HCV infection sometimes results in clearance (15%), 7 a state that is recognized when HCV RNA cannot be detected in multiple blood samples from a patient with HCV-specific antibodies. 1 HCV clearance is known to occur less often in blacks people, alcohol users, and HIVinfected persons.…”

Section: Introductionmentioning

confidence: 99%

Single nucleotide polymorphisms and haplotypes in the IL10 region associated with HCV clearance

et al. 2005

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Hepatitis C virus (HCV) is an infectious blood-borne pathogen that usually persists as a chronic infection. However, approximately 15% of the time, patients can clear the virus, indicating that host differences could be critical in determining the course of HCV infection. The inflammatory response is crucial to resolving or failing to resolve an acute HCV infection. Some previous reports have implicated interleukin 10 (IL10) polymorphisms with successful anti-HCV therapy and natural viral clearance. We tested 54 single nucleotide polymorphisms (SNPs) in the IL10 region (7300 kb and 24 within the IL10 gene itself), which contains 13 genes including the IL10 immunomodulatory paralogs IL19, IL20, and IL24, for association with HCV clearance vs persistence. SNPs from two haplotype block regions, one at IL10 and the other from IL19/IL20, were associated with HCV clearance in African Americans (91 clearance cases and 183 chronically infected matched controls; P ¼ 0.05-0.002) while with expectation-maximization algorithm-reconstructed haplotypes, these associations remained (P ¼ 0.05-0.002). However, no significant associations were detected in European Americans (108 clearance and 245 chronic). Our results indicate that variants of the immunomodulatory IL10 and IL19/IL20 genes may be involved in natural clearance of HCV in the African-American population.

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“…[1][2][3][4] The Centers for Disease Control and Prevention (CDC) has recommended that individuals born between 1945 and 1965 be uniformly educated, screened, and properly linked to HCV care and treatment, given that this cohort accounts for 75 % of infections. [5][6][7][8][9] The economic burden from HCV-related morbidity and mortality in the near term will largely be attributed to this cohort as the HCV-positive population ages and develops cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

et al. 2015

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Hepatitis C virus (HCV) infection continues to disproportionately affect incarcerated populations. New HCV drugs present opportunities and challenges to address HCVin corrections. The goal of this study was to evaluate the impact of the treatment costs for HCV infection in a state correctional population through a budget impact analysis comparing differing treatment strategies. Electronic and paper medical records were reviewed to estimate the prevalence of hepatitis C within the Rhode Island Department of Corrections. Three treatment strategies were evaluated as follows: (1) treating all chronically infected persons, (2) treating only patients with demonstrated fibrosis, and (3) treating only patients with advanced fibrosis. Budget impact was computed as the percentage of pharmacy and overall healthcare expenditures accrued by total drug costs assuming entirely interferon-free therapy. Sensitivity analyses assessed potential variance in costs related to variability in HCV prevalence, genotype, estimated variation in market pricing, length of stay for the sentenced population, and uptake of newly available regimens. Chronic HCV prevalence was estimated at 17 % of the total population. Treating all sentenced inmates with at least 6 months remaining of their sentence would cost about $34 million-13 times the pharmacy budget and almost twice the overall healthcare budget. Treating inmates with advanced fibrosis would cost about $15 million. A hypothetical 50 % reduction in total drug costs for future therapies could cost $17 million to treat all eligible inmates. With immense costs projected with new treatment, it is unlikely that correctional facilities will have the capacity to treat all those afflicted with HCV. Alternative payment strategies in collaboration with outside programs may be necessary to curb this epidemic. In order to improve care and treatment delivery, drug costs also need to be seriously reevaluated to be more accessible and equitable now that HCV is more curable.

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The burden of hepatitis C in the United States

Cited by 274 publications

References 16 publications

Chronic liver disease mortality in the United States, 1990-1998

Chronic liver disease mortality in the United States, 1990-1998

Single nucleotide polymorphisms and haplotypes in the IL10 region associated with HCV clearance

A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

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