title: The changing burden of hepatitis C virus infection in the United States: model-based predictions.
abstract: BACKGROUND
  Chronic hepatitis C virus (HCV) infection causes a substantial health and economic burden in the United States. With the availability of direct-acting antiviral agents, recently approved therapies and those under development, and 1-time birth-cohort screening, the burden of this disease is expected to decrease.
  
  
  OBJECTIVE
  To predict the effect of new therapies and screening on chronic HCV infection and associated disease outcomes.
  
  
  METHODS
  Individual-level state-transition model.
  
  
  METHODS
  Existing and anticipated therapies and screening for HCV infection in the United States.
  
  
  METHODS
  Total HCV-infected population in the United States.
  
  
  METHODS
  The number of cases of chronic HCV infection and outcomes of advanced-stage HCV infection.
  
  
  RESULTS
  The number of cases of chronic HCV infection decreased from 3.2 million in 2001 to 2.3 million in 2013. One-time birth-cohort screening beginning in 2013 is expected to identify 487,000 cases of HCV infection in the next 10 years. In contrast, 1-time universal screening could identify 933,700 cases. With the availability of highly effective therapies, HCV infection could become a rare disease in the next 22 years. Recently approved therapies for HCV infection and 1-time birth-cohort screening could prevent approximately 124,200 cases of decompensated cirrhosis, 78,800 cases of hepatocellular carcinoma, 126,500 liver-related deaths, and 9900 liver transplantations by 2050. Increasing the treatment capacity would further reduce the burden of HCV disease.
  
  
  CONCLUSIONS
  Institutionalized patients with HCV infection were excluded, and empirical data on the effectiveness of future therapies and on the future annual incidence and treatment capacity of HCV infection are lacking.
  
  
  CONCLUSIONS
  New therapies for HCV infection and widespread implementation of screening and treatment will play an important role in reducing the burden of HCV disease. More aggressive screening recommendations are needed to identify a large pool of infected patients.
  
  
  BACKGROUND
  National Institutes of Health.
authors.forename: Mina
authors.initials: M
authors.lastname: Kabiri
authors.forename: Alison B
authors.initials: AB
authors.lastname: Jazwinski
authors.forename: Mark S
authors.initials: MS
authors.lastname: Roberts
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Schaefer
authors.forename: Jagpreet
authors.initials: J
authors.lastname: Chhatwal
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008403:Mass Screening; D008954:Models, Biological; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents
references.citation: Liver Int. 2013 Feb;33 Suppl 1:68-79
references.pmid: 23286849
references.citation: N Engl J Med. 2000 Dec 7;343(23):1666-72
references.pmid: 11106715
references.citation: Hepatology. 2013 Jun;57(6):2164-70
references.pmid: 23280550
references.citation: N Engl J Med. 2013 May 16;368(20):1907-17
references.pmid: 23675659
references.citation: Ann Intern Med. 2012 Feb 21;156(4):271-8
references.pmid: 22351712
references.citation: Clin Liver Dis (Hoboken). 2012 Mar 06;1(1):2-5
references.pmid: 31186836
references.citation: MMWR Recomm Rep. 2012 Aug 17;61(RR-4):1-32
references.pmid: 22895429
references.citation: Value Health. 2012 Sep-Oct;15(6):812-20
references.pmid: 22999130
references.citation: Lancet Infect Dis. 2013 May;13(5):401-8
references.pmid: 23499158
references.citation: Gastroenterology. 2004 Nov;127(5 Suppl 1):S27-34
references.pmid: 15508094
references.citation: Clin Infect Dis. 2012 Aug;55(3):414-7
references.pmid: 22491341
references.citation: N Engl J Med. 2007 Jul 12;357(2):124-34
references.pmid: 17625124
references.citation: N Engl J Med. 2011 Jun 9;364(23):2199-207
references.pmid: 21631316
references.citation: Hepatology. 2012 Nov;56(5):1591-2
references.pmid: 22807004
references.citation: J Hepatol. 2009 Jan;50(1):89-99
references.pmid: 18977551
references.citation: Hepatology. 2020 Feb;71(2):686-721
references.pmid: 31816111
references.citation: N Engl J Med. 2011 Jun 23;364(25):2405-16
references.pmid: 21696307
references.citation: Am J Transplant. 2013 Jan;13 Suppl 1:73-102
references.pmid: 23237697
references.citation: JAMA. 2012 Dec 26;308(24):2584-93
references.pmid: 23268517
references.citation: N Engl J Med. 2013 May 16;368(20):1878-87
references.pmid: 23607594
references.citation: N Engl J Med. 2013 May 16;368(20):1931-2
references.pmid: 23607592
references.citation: Clin Gastroenterol Hepatol. 2005 Oct;3(10 Suppl 2):S97-S101
references.pmid: 16234071
references.citation: Br J Clin Pharmacol. 2013 Apr;75(4):931-43
references.pmid: 22882367
references.citation: Hepatology. 2009 Dec;50(6):1750-5
references.pmid: 19824079
references.citation: Gastroenterology. 2010 Feb;138(2):513-21, 521.e1-6
references.pmid: 19861128
references.citation: N Engl J Med. 2012 Jan 19;366(3):216-24
references.pmid: 22256805
references.citation: N Engl J Med. 2011 Jun 23;364(25):2417-28
references.pmid: 21696308
references.citation: Ann Intern Med. 2013 Sep 3;159(5):364-5
references.pmid: 23797155
references.citation: Ann Intern Med. 2014 Mar 4;160(5):293-300
references.pmid: 24737271
references.citation: Ann Intern Med. 2013 Sep 3;159(5):349-57
references.pmid: 23798026
references.citation: N Engl J Med. 2011 Mar 31;364(13):1195-206
references.pmid: 21449783
references.citation: Hepatology. 2009 Apr;49(4):1335-74
references.pmid: 19330875
references.citation: J Hepatol. 2001 May;34(5):730-9
references.pmid: 11434620
references.citation: Hepatology. 2012 May;55(5):1344-55
references.pmid: 22135116
references.citation: N Engl J Med. 2014 May 22;370(21):1973-82
references.pmid: 24725237
references.citation: Public Health Rep. 2007;122 Suppl 2:55-62
references.pmid: 17542455
references.citation: Clin Infect Dis. 2012 May;54(9):1259-71
references.pmid: 22412061
references.citation: Clin Gastroenterol Hepatol. 2014 Aug;12(8):1381-3
references.pmid: 24607698
references.citation: N Engl J Med. 2013 Jan 3;368(1):34-44
references.pmid: 23281974
references.citation: Lancet. 2014 Feb 8;383(9916):515-23
references.pmid: 24209977
references.citation: J Viral Hepat. 2000 May;7(3):196-202
references.pmid: 10849261
references.citation: Hepatology. 1999 Oct;30(4):1054-8
references.pmid: 10498659
references.citation: Ann Intern Med. 2006 May 16;144(10):705-14
references.pmid: 16702586
references.citation: Liver Int. 2012 Feb;32 Suppl 1:113-9
references.pmid: 22212581
references.citation: Ann Intern Med. 2012 Feb 21;156(4):263-70
references.pmid: 22056542
references.citation: Gastroenterology. 2009 May;136(5):1618-28.e2
references.pmid: 19208349
references.citation: Dig Liver Dis. 2011 Jan;43(1):66-72
references.pmid: 20739252
references.citation: Hepatology. 2012 Mar;55(3):664-5
references.pmid: 22174100
references.citation: N Engl J Med. 2014 Apr 17;370(16):1552-3
references.pmid: 24725236
references.citation: N Engl J Med. 2011 Mar 31;364(13):1207-17
references.pmid: 21449784
references.citation: N Engl J Med. 2013 May 16;368(20):1867-77
references.pmid: 23607593
references.citation: Ann Intern Med. 2002 Feb 19;136(4):288-92
references.pmid: 11848726
references.citation: N Engl J Med. 2011 Jun 23;364(25):2429-38
references.pmid: 21696309
references.citation: J Hepatol. 2015 May;62(5):1040-6
references.pmid: 25450208