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Study Predicts Hepatitis C Will Become Rare Disease in Coming Decades

Findings support value of direct-acting antivirals and universal screening

Effective new drugs and screening would make hepatitis C a rare disease by 2036, according to a computer simulation conducted by the University of Texas MD Anderson Cancer Center and the University of Pittsburgh Graduate School of Public Health. The results of the simulation were reported August 5 in the Annals of Internal Medicine.

“Hepatitis C (HCV) is the leading cause of liver cancer and accounts for more than 15,000 deaths in the U.S. each year,” said corresponding author Jagpreet Chhatwal, PhD.

“If we can improve access to treatment and incorporate more aggressive screening guidelines, we can reduce the number of chronic HCV cases, prevent more cases of liver cancer, and reduce liver-related deaths,” Chhatwal said.

HCV — a virus transmitted through the blood — is spread by sharing needles, by the use of contaminated medical equipment, and by tattoo and piercing equipment that has not been fully sterilized. Those at the highest risk for exposure are baby boomers — people born between 1945 and 1965. Widespread screening of the U.S. blood supply for hepatitis C began in 1992. Most people were infected through blood transfusions or organ transplants before 1992.

Baby boomers account for 75% of the estimated 2.7 to 3.9 million people infected with HCV in the U.S. Half of people with the virus are not aware that they are infected.

In the new study, Chhatwal and his colleagues used a mathematical model with information from several sources, including more than 30 clinical trials, to predict the effect of direct-acting antivirals and the use of screening for chronic HCV cases.

The researchers developed a computer model to analyze and predict disease trends from 2001 to 2050. The model was validated with historical data, including a recently published national survey on HCV prevalence. The researchers predicted that, with new screening guidelines and therapies, HCV will affect only 1 in 1,500 people in the U.S. by 2036.

In the study, the researchers predict that a one-time universal screening could identify 933,700 HCV cases. They also predict that universal screening and timely treatment can make HCV a rare disease within the next 12 years. Such screening can further prevent 161,500 liver-related deaths; 13,900 liver transplants; and 96,300 cases of hepatocellular carcinoma — the most common type of liver cancer.

Chhatwal said that the availability of highly effective therapies and screening updates provide a great opportunity to tackle the hepatitis C epidemic. He added, however, that “the new treatment that costs $1,000 a day has been a subject of debate and can become a barrier to timely access to all patients.”

Sources: Annals of Internal Medicine; July 5, 2014; and MD Anderson Cancer Center; July 4, 2014.

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