In the US, 1 in every 100 people has chronic hepatitis C. But according to a new study published in the Annals of Internal Medicine, current screening and treatments for the disease will make it “rare” by the year 2036, affecting only 1 in every 1,500 people. They note this could even happen 10 years earlier if treatment and screening methods are further improved.
These findings come from a predictive computer model created by researchers at the University of Pittsburgh Graduate School of Public Health, PA, in collaboration with investigators from the University of Texas MD Anderson Cancer Center.
Hepatitis C is an infection caused by the hepatitis C virus (HCV). Mainly spread through contact with blood from an HCV-infected individual, hepatitis C is the leading cause of chronic liver disease in the US and is accountable for more than 15,000 deaths each year.
Around 70-80% of individuals with HCV, however, do not experience any symptoms, meaning many people are not aware they have it until they undergo blood screening.
Because of this, in 2012, the Centers for Disease Control and Prevention (CDC) and the US Preventive Services Task Force recommended that everyone born between 1945 and 1965 – deemed “baby boomers,” a population that incorporates around 81% of people with chronic HCV infection – should undergo a one-time screening for HCV.
As well as improved screening recommendations, treatment for hepatitis C has come a long way. Up until 2 years ago, there were only two drugs approved by the Food and Drug Administration (FDA) to treat the virus – pegylated interferon, which can be used alone, and ribavirin, which is used in combination with pegylated interferon.
But earlier this year came the first drug regimens for hepatitis C that could be taken orally. Sofosbuvir – brand name sovaldi – is a once-daily pill approved to treat HCV genotypes 1, 2, 3 and 4. It is used in combination with ribavirin or both ribavirin and pegylated interferon. Such regimens have demonstrated high effectiveness, making the virus undetectable in the blood of some patients.
In this latest study – led by Mina Kabiri, a doctoral student of the Department of Health Policy and Management at the University of Pittsburgh Graduate School of Public Health – the team accounted for recent improvements in HCV screening and treatment to create their predictive model of HCV prevalence in the US, using data from the National Health and Nutrition Examination Survey (NHANES) and an array of clinical studies.
Their model, they say, uses the data to predict the number of people in the US with HCV infection at any given time between 2001 and 2050, while taking into account a range of different scenarios.
To validate the model, the team used it to predict HCV prevalence in the US between 2003-10. It reported 2.7 million cases – the same number reported by NHANES.
Using the model to predict long-term prevalence of HCV, the researchers estimate that the one-time screening of baby boomers currently in action can help identify 487,000 HCV cases in the next decade.
From this, they say that current screening guidelines, along with the highly effective treatments available, could make hepatitis C a rare disease in the next 22 years – with only 1 in 1,500 people becoming infected.
But the team calculated that if one-time screening was offered to all Americans – allowing more individuals to receive earlier treatment – 933,700 cases could be identified in the next 12 years, meaning hepatitis C could become a rare disease 10 years earlier than with current screening recommendations.
Furthermore, they estimate that universal HCV screening would further prevent 161,500 liver-related deaths, 13,900 liver transplants and 96,300 cases of hepatocellular carcinoma – the most common form of liver cancer.
“Although recent screening recommendations are helpful in decreasing the chronic HCV infection rates, more aggressive screening recommendations and ongoing therapeutic advances are essential to reducing the burden, preventing liver-related deaths and eventually eradicating HCV,” says senior author Jagpreet Chhatwal, PhD, assistant professor of health services research at the University of Texas MD Anderson Cancer Center.
“Making hepatitis C a rare disease would be a tremendous, life-saving accomplishment. However, to do this, we will need improved access to care and increased treatment capacity, primarily in the form of primary care physicians who can manage the care of infected people identified through increased screening.”
However, the researchers point out that offering universal screening for HCV would bring increased costs with it. The current oral treatment regimen for HCV alone, for example, costs $1,000 a day.
The team plans to conduct further research looking at how the reduction of deaths and transplants as a result of increased HCV screening and treatment could counteract the rise in costs.
Medical News Today recently reported on a study published in the journal Hepatology, which identified the global prevalence of HCV genotypes. They found that HCV genotype 1 is the most common, accounting for 46% of all hepatitis C infections.