Deuffic S, Buffat L, Poynard T, Valleron A J
Unité de Recherche "Epidémiologie et Sciences de l'Information" (INSERM U444), Faculté de Médecine Saint-Antoine, Paris, France.
Hepatology. 1999 May;29(5):1596-601. doi: 10.1002/hep.510290528.
A backcalculation approach allows a reconstruction of the history of hepatitis C virus (HCV) infection in France and predictions of mortality from hepatocellular carcinoma (HCC) related to the virus. The model uses information from the literature about the natural history of the disease, epidemiological data about infected subjects in three French cohorts, and mortality data from national statistics. It seeks to determine the annual transition probabilities from chronic hepatitis to cirrhosis and the HCV incidence per year in the past. These unknowns are found by fitting the observed deaths from HCC that are attributable to HCV. Optimal values for these unknowns then allow to project the number of HCC deaths attributable to HCV for each year through 2025 (for patients infected before 1996). The model traces the HCV epidemic in France back to around the 1940s. It predicts that HCC mortality related to HCV will continue to increase through 2020 in the absence of treatment, with a 150% increase in the yearly incidence among men and 200% among women. The model also confirms that progression to cirrhosis depends strongly on sex and age. At any age, the annual probability of progression is 10 times greater for men than for women. Moreover, for men aged between 61 and 70 years, this probability is 300 times greater than that for men aged between 21 and 40 years.
一种反向推算方法能够重建法国丙型肝炎病毒（HCV）感染的历史，并预测与该病毒相关的肝细胞癌（HCC）死亡率。该模型使用了文献中关于疾病自然史的信息、法国三个队列中感染受试者的流行病学数据以及国家统计的死亡率数据。它试图确定从慢性肝炎到肝硬化的年度转变概率以及过去每年的HCV发病率。通过拟合归因于HCV的HCC观察死亡人数来找到这些未知量。这些未知量的最佳值随后可用于预测到2025年（针对1996年前感染的患者）每年归因于HCV的HCC死亡人数。该模型将法国的HCV流行追溯到20世纪40年代左右。它预测在没有治疗的情况下，与HCV相关的HCC死亡率到2020年将持续上升，男性的年发病率增加150%，女性增加200%。该模型还证实，进展为肝硬化在很大程度上取决于性别和年龄。在任何年龄，男性进展的年度概率比女性高10倍。此外，对于年龄在61至70岁之间的男性，这一概率比年龄在21至40岁之间的男性高300倍。
