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Med Decis Making. 2004 Jan-Feb;24(1):20-9.

Estimating the prognosis of hepatitis C patients infected by transfusion in Canada between 1986 and 1990.

Author information

1
Toronto General Hospital, ES9 408, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. murray.krahn@uhn.on.ca.

Abstract

OBJECTIVE:

To develop a natural history model for chronic hepatitis C virus (HCV) infection to determine allocation of compensatory funds to Canadians who acquired HCV through the blood supply from 1986 through 1990.

METHODS:

A Markov cohort simulation model for HCV prognosis was developed, using content experts, published data, posttransfusion look-back data, and a national survey.

RESULTS:

The mortality rate in transfusees is high (46% at 10 years), although HCV-related deaths are rare. Only 14% develop cirrhosis at 20 years (95% confidence interval, 0%--44%), but 1 in 4 will eventually develop cirrhosis, and 1 in 8 will die of liver disease.

CONCLUSIONS:

This unique application of Markov cohort simulation and epidemiologic methods provides a state-of-the-art estimate of HCV prognosis and has allowed compensation decisions to be based on the best available evidence.

PMID:
15005951
DOI:
10.1177/0272989X03261568
[Indexed for MEDLINE]

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