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J Hepatol. 2008 Aug;49(2):175-83. doi: 10.1016/j.jhep.2008.04.012. Epub 2008 May 20.

Impact of viral eradication on mortality related to hepatitis C: a modeling approach in France.

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1
CTRS-INSERM U795, CHRU Lille, Lille, France. sylvie.burban@neuf.fr

Abstract

BACKGROUND/AIMS:

In France, two recent studies enabled modeling of the impact of viral eradication on HCV mortality.

METHODS:

The French HCV population was simulated from infection to death using a computer-based model. We took into account the impact of alcohol, present screening and antiviral therapy to predict 2006--2025 HCV mortality and to assess the impact of viral eradication.

RESULTS:

In 2006, the model estimated that among HCV-RNA+, 55% were F0-F1, 18% F2, 22% F3-F4 and 6% had liver complications. The mortality ratio was 11-fold higher in alcoholic patients 40-65 years old. Current therapy will save 14,400 (95% CI, 13,900-15,000) lives compared to absence of therapy. Sensitivity analyses did not change the main results. Contrary to guidelines, if patients F<2 were treated in the same proportions as those with F> or = 2,700 (95% CI, 700-750) lives would be saved. If screening were to reach 75% in 2010, 4 years earlier than model expectation, 950 (95% CI, 900-1000) lives would be saved. If a new molecule improving eradication for genotype 1/4 by 40% were to become available in 2010, 1500 (95% CI, 1400-1600) lives would be saved.

CONCLUSIONS:

Current therapy is reducing HCV mortality. Therapeutic guidelines must take into account their impact on HCV mortality.

PMID:
18538441
DOI:
10.1016/j.jhep.2008.04.012
[Indexed for MEDLINE]
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