title: Epidemiology of hepatitis C virus infection in a large Israeli health maintenance organization.
abstract: Hepatitis C affects an estimated 130 million people worldwide and is a major cause of chronic liver disease. This retrospective database study aims to describe the epidemiology of HCV-infected patients in Maccabi Healthcare Services, a 2-million-member health maintenance organization in Israel. HCV was identified by cross-linking diagnoses, laboratory data, and dispensed HCV treatment (1993-2013). The point-prevalence of HCV in 2012 and annual incidence of newly-diagnosed HCV during 2003-2012 (index period) were calculated. The age-adjusted prevalence of HCV was 5.19/1,000 population (n = 10,648). The highest prevalence was found among males and in patients aged 35-54 years. Two thirds of HCV-infected patients were immigrants from the former Soviet Union (FSU). HCV genotype 1 was predominant (67%). A total of 6,150 patients were newly diagnosed with HCV infection during the index period. The age-standardized rate of newly-diagnosed HCV declined from over 50/100,000 (2003) to 15/100,000 (2012). This rate was highest in males from the FSU, particularly for birth cohorts in 1950-70. The study results suggest that the reported incidence of HCV infection in Israel is declining, while prevalence is particularly high among FSU immigrants and genotype 1 is predominant. As the HCV treatment landscape evolves, these estimates can inform future studies and health technology assessments.
authors.affiliation: Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Clara
authors.initials: C
authors.lastname: Weil
authors.affiliation: Global Health Outcomes, Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Chizoba
authors.initials: C
authors.lastname: Nwankwo
authors.affiliation: Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mira
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Kenet
authors.affiliation: Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.affiliation: Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054242:Emigrants and Immigrants; D005260:Female; D005838:Genotype; D006279:Health Maintenance Organizations; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014586:USSR / Q000208:ethnology; D055815:Young Adult
keywords: HCV genotype; antiviral therapy; comorbidities; healthcare utilization; incidence; prevalence