U.S. hepatitis C burden may ease in coming decades: study

By Andrew M. Seaman

NEW YORK (Reuters Health) - Hepatitis C may become a "rare" disease in the U.S. in about 20 years, according to a new computer model.

About one in 100 people are currently infected with the hepatitis C virus in the U.S. but that may drop to about one in 1,500 people by 2036 thanks to new medicines and increased screening regimens, researchers suggest.

"We were pleasantly surprised that in the next 22 years we could make this a rare disease," said Jagpreet Chhatwal, the study's senior author from The University of Texas MD Anderson Cancer Center in Houston.

The researchers write in the Annals of Internal Medicine that about 3.2 million people in the U.S. have chronic hepatitis C infections that cost the country about $6.5 billion per year.

Treatment of hepatitis C infections recently changed with the availability of new antiviral medicines in 2011 and the more recent release of pill from Gilead Sciences known as Sovaldi to treat the virus.

And the CDC and the government-backed U.S. Preventive Services Task Force recently endorsed expanded hepatitis C screenings for every adult born between 1945 and 1965.

"We were curious how the trend will change," Chhatwal said. "How will it dip or drop?"

For the study, Chhatwal and his colleagues used a computer model to estimate how the benefits of the new medicines and expanded screenings might change the burden of hepatitis C infection in the U.S. during the coming decades.

Under current conditions, hepatitis C would become a "rare" disease, defined as a condition affecting no more than one in 1,500 people, by 2036. The U.S. could reach that goal by 2026 by adopting a more aggressive screening protocol, they add.

The researchers say the current screening regimen would identify about 487,000 cases of hepatitis C infection within the next 10 years. That could increase to 933,700 cases if a one-time, universal screening policy is adopted.

Chhatwal said additional research is needed about the effects of expanded screening for hepatitis C infections.

Still, under current conditions, he and his team estimates that 124,200 cases of decompensated cirrhosis, 78,800 cases of liver cancer, 126,500 liver-related deaths and 9,900 liver transplants may be prevented by 2050.

"We are moving in a positive direction," Chhatwal said. "These updates and advances we expect will help patients and the healthcare system as well."

He cautions that it will only be possible if people have timely and affordable treatment for hepatitis C infections.

SOURCE: http://bit.ly/1kiV1HZ

Ann Intern Med 2014.