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| disease burden |
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• Hepatitis C is a serious liver disease
caused by the Hepatitis C Virus (HCV) |
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• Infection with HCV is a silent epidemic |
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• Approximately 1 out of every 50 patients
in a primary care practice is infected |
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• Of the estimated 3.2 million Americans with
hepatitis C, more than half are unaware of
their
infection, and only 12% have received treatment |
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The Centers for Disease Control and Prevention
(CDC) estimates that some 3.2 million Americans
have been infected with HCV. About 30,000 new
infections occur annually. Most will develop
into chronic infection, increasing the risk for
developing chronic liver diseases such as
cirrhosis and cancer. HCV now infects more than
3 times more Americans than HIV. |
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Persons with chronic HCV are at risk for
developing cirrhosis, liver failure, liver
cancer, and death. However, the majority of
people with chronic HCV are unaware of their
infection because signs and symptoms do not
usually develop until the liver disease is
advanced. Most diagnoses of chronic HCV are made
accidentally when asymptomatic individuals
attempt to donate blood or when blood is drawn
for routine medical evaluations or during
insurance physical examinations. |
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Current estimates indicate that as many as 5
million people are infected with HCV in the US,
with the highest prevalence occurring in those
born between 1945 and 1965 (1). According to the
CDC, of every 100 persons infected with HCV,
approximately 75-85 will go on to develop
chronic infection, 60-70 will go on to develop
chronic liver disease, 5-20 will go on to
develop cirrhosis over a period of 20-30 years,
and 1-5 will die from the consequences of
chronic infection (liver cancer or cirrhosis).
HCV-associated, end-stage liver disease is the
most frequent indication for liver
transplantation in adults (2). |
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Approximately 75-80% of persons with chronic viral hepatitis C were born between 1945 and 1965,
with the strongest risk factor for infection
being a history of injection drug use. The sheer
number of relatively young persons with chronic
HCV infection who may develop complications as
they age has led to the projection that related
morbidity and mortality, as well as the medical
care costs attributable to hepatitis C virus
(HCV) infection, will increase dramatically in
the next decade (3,4). This large pool of
surviving patients remains at risk of
progressive disease as the duration of their
infection increases and will lead to a dramatic
increase in the number patients with liver
failure, HCC, and death caused by liver disease.
The total economic burden of HCV has been
estimated to be about $184 billion in the United
States for the period between 2010 and 2019 (5). |
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Major advances in the treatment of Hepatitis C have been made in the last decade and more promising treatments are on the horizon. Hepatitis C can be cured. However, there is a critical need to improve awareness, patient screening, surveillance and integration of care. The purpose of this CLDF initiative is to help physicians, community based organizations and other institutions properly screen patients for HCV, link the patients that require follow-up care with the appropriate resources, and capture screening/linkage to care data for future publication in order to improve public health practice. |
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| References: |
| 1. |
Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#section1. Accessed October 21, 2009. |
| 2. |
Centers for Disease Control and Prevention, "Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease," Morbidity And Mortality Weekly Report, vol. 47, no. RR19, pp. 1-39, 1998. |
| 3. |
Dienstag J.L., McHutchison J.G. American gastroenterological association medical position statement on the management of hepatitis C (2006) Gastroenterology, 130 (1), pp. 225-230. |
| 4. |
Kamal SM. Acute hepatitis C: a systematic review. Am J Gastroenterol. 2008;103(5):1283-1297; quiz 1298. |
| 5. |
Shah BB, Wong JB. The economics of hepatitis C virus. Clin Liver Dis 2006;10:717-734. |
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