Hepatitis C could be on the road to becoming a rare disease by 2036, thanks to potent new drugs and timely screening, according to researchers, who base this prediction on a computer simulation.
Hepatitis C a viral disease that spurs inflammation of the liver. Hepatitis C infection is induced by the hepatitis C virus (HCV). The disease is stealthy because an infected person may have no symptoms until grave liver damage has occurred.
The researchers, from The University of Texas MD Anderson Cancer Center, Houston, and the University of Pittsburgh Graduate School of Public Health, Pittsburgh, devised and validated a computer model to assess and predict trends from 2001 to 2050. They forecast that, in light of the new screening guidelines and available treatments, HCV will only affect one in 1,500 people in the United States by 2036.
A person can become infected with hepatitis C if blood from an individual infected with hepatitis C enters their body. For example, HCV is spread by sharing of needles with someone who has hepatitis C, the use of contaminated medical equipment, and by tattoo and piercing equipment that has not been fully sterilized. People who have been on long-term kidney dialysis, have frequent contact with blood at work, or have unprotected sex with a someone who has hepatitis C are also at risk.
Baby Boomers (the generation of Americans born between 1945 and 1965) comprise 75 percent of the estimated 2.7 to 3.9 million people infected in the United States, and they are at greatest risk for exposure to HCV. [Some 76 million people were born during this time span.]
More than half of those diagnosed with HCV were infected through blood transfusions or organ transplants prior to 1992-which is when extensive screening of the US blood supply for hepatitis C began. As half of those with HCV do not know they are infected, the Centers for Disease Control and Prevention (CDC) calls for a one-time HCV screening for this group.
HCV is the foremost cause of liver cancer and is responsible for more than 15,000 deaths in the United States each year, according to Jagpreet Chhatwal, PhD, assistant professor of Health Services Research at MD Anderson, and corresponding author on the study. Chhatwal says improved access to treatment and embrace of more aggressive screening guidelines could lead to a reduction in the number of chronic HCV cases, thwart more cases of liver cancer, and curtail liver-related deaths.
The study used a mathematical model that drew information from numerous sources to predict the impact of novel new therapies-known as direct-acting antivirals-and the implementation of screening for chronic HCV cases.
Chhatwal says that despite its impact, the CDC's new screening guideline does not identity the large number of HCV patients who would progress to advanced disease stages without treatment and could die. In the study, the research team envisioned that a one-time universal screening could identify can make HCV a rare disease in the next 12 years. The one-time universal screening could further prevent 161,500 liver related deaths, 13,900 liver transplants, and 96,300 cases of hepatocellular carcinoma, which accounts for most liver cancers.
Image: Jagpreet Chhatwal, PhD