Estimating the Future Health Burden of HIV and Chronic Hepatitis C

HIV and chronic hepatitis C virus (HCV) infection both represent significant burdens on the healthcare system, both now and in the future.

As reported in the February 2007 Journal of Viral Hepatitis, researchers estimated the future burden of the 2 diseases in the United States through the year 2030. The investigators developed 2 back-calculation models of the HIV and the HCV epidemics based on U.S. epidemiological data regarding disease prevalence, age and sex of incident cases, AIDS and hepatocellular carcinoma (HCC) mortality, and general population mortality from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO).

Results

• Based on the HCV back-calculation model, HCV incidence peaked in 1984 at 350,000 new infections, and then fell to about 77,000 in 1998.

• Based on the HIV back-calculation model, HIV incidence reached its maximum in 1989 at 142,000 new infections, and then declined to 79,000 in 1998.

• Mortality related to HCV (death from liver failure or HCC) rose from about 3700 in 1998, and is expected to peak at about 13,000 in 2030.

• Predicted HCV mortality is predicted to fall only if there is increased treatment access to or more effective antiviral therapy.

• For comparison, observed HIV-related mortality was 14,400 in 1998, and is projected to be 4200 in 2030.

Conclusion

In conclusion, the authors wrote, "With the availability of effective highly active antiretroviral therapy for HIV infection, mortality from HIV appears to have declined substantially, whereas HCV-related deaths as a result of pre-1999 infections will likely continue to increase over the next 25 years."

02/06/07

Reference
S Dueffic-Burban, T Poynard, M S Sulkowski, and others. Estimating the future health burden of chronic hepatitis C and human immunodeficiency virus infections in the United States. Journal of Viral Hepatitis 14(2): 107-115. February 2007.