Wong J B, McQuillan G M, McHutchison J G, Poynard T
Department of Medicine, New England Medical Center, Tupper Research Institute, Tufts University School of Medicine, Boston, Mass., USA.
Am J Public Health. 2000 Oct;90(10):1562-9. doi: 10.2105/ajph.90.10.1562.
This study estimated future morbidity, mortality, and costs resulting from hepatitis C virus (HCV).
We used a computer cohort simulation of the natural history of HCV in the US population.
From the year 2010 through 2019, our model projected 165,900 deaths from chronic liver disease, 27,200 deaths from hepatocellular carcinoma, and $10.7 billion in direct medical expenditures for HCV. During this period, HCV may lead to 720,700 years of decompensated cirrhosis and hepatocellular carcinoma and to the loss of 1.83 million years of life in those younger than 65 at a societal cost of $21.3 and $54.2 billion, respectively. In sensitivity analysis, these estimates depended on (1) whether patients with HCV and normal transaminase levels develop progressive liver disease, (2) the extent of alcohol ingestion, and (3) the likelihood of dying from other causes related to the route of HCV acquisition.
Our results confirm prior Centers for Disease Control and Prevention projections and suggest that HCV may lead to a substantial health and economic burden over the next 10 to 20 years.
本研究估算了丙型肝炎病毒（HCV）导致的未来发病率、死亡率及成本。
我们对美国人群中HCV的自然史进行了计算机队列模拟。
从2010年到2019年，我们的模型预测有165,900人死于慢性肝病，27,200人死于肝细胞癌，HCV的直接医疗支出为107亿美元。在此期间，HCV可能导致720,700年失代偿期肝硬化和肝细胞癌，并导致65岁以下人群损失183万年的寿命，社会成本分别为213亿美元和542亿美元。在敏感性分析中，这些估计取决于：（1）HCV且转氨酶水平正常的患者是否会发展为进行性肝病；（2）酒精摄入程度；（3）因与HCV感染途径相关的其他原因死亡的可能性。
我们的结果证实了美国疾病控制与预防中心之前的预测，并表明HCV可能在未来10至20年导致巨大的健康和经济负担。
