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Future Trends of Hepatitis C-related Cirrhosis
and Hepatocellular Carcinoma in Greece
The
epidemic of hepatitis
C virus (HCV) infection is a major public health issue in Greece.
Greek researchers conducted a comprehensive analysis to estimate
future HCV-related
morbidity and mortality, using a model which is the first to take
into account currently available
treatments.
The standard of care in the US for the treatment of chronic
hepatitis C is pegylated interferon.
The
investigators reconstructed the incident infections per year
in the past that progressed to chronic hepatitis
C (CHC) in Greece. Then, the natural
history of the disease was simulated in subcohorts of newly infected
subjects in the presence or absence of treatment using yearly
estimates of the number of treated patients obtained from
national databases.
Annual
estimates of the incidence and prevalence of CHC by fibrosis stage, hepatocellular
carcinoma (HCC)
and mortality were obtained up to 2030.
Results
The current proportion of naïve CHC patients receiving treatment
in Greece is 1.2% per year.
Treatment
of 1.2-10% of naïve CHC patients per year would reduce the
cumulative number of incident cirrhosis and HCC cases from
2002 to 2030 by 10.8-39.4% and 12.8-39.8%, respectively and
decrease the number of prevalent cirrhosis and HCC cases in
2030 by approximately 17-48% compared with the number estimated
under the assumption of no treatment.
Approximately
17 cirrhosis cases or six HCC cases or 10 premature deaths
would be prevented for every 100 treated patients.
However,
the prevalent cirrhotic/HCC cases because of HCV and HCV-related
deaths would not plateau until 2030.
Based
on these results, the study authors conclude, “Despite the
introduction of effective treatment, HCV-related morbidity
and mortality will likely increase during the next 20-30 years
in Greece.”
“Intensive
primary prevention efforts coupled with increased access to
the currently available treatments are necessary to control
the chronic consequences of the HCV epidemic.”
10/14/05
Reference
V
Sypsa and others. Future trends of HCV-related cirrhosis and
hepatocellular carcinoma under the currently available treatments.
Journal
of Viral Hepatitis 12(5): 543-550. September 2005.
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