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美国慢性丙型肝炎病毒(HCV)疾病负担和成本。

Chronic hepatitis C virus (HCV) disease burden and cost in the United States.

机构信息

Center for Disease Analysis, Louisville, CO, USA.

出版信息

Hepatology. 2013 Jun;57(6):2164-70. doi: 10.1002/hep.26218. Epub 2013 May 6.

DOI:10.1002/hep.26218
PMID:23280550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3763475/
Abstract

UNLABELLED

Hepatitis C virus (HCV) infection is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. A better understanding of HCV disease progression and the associated cost can help the medical community manage HCV and develop treatment strategies in light of the emergence of several potent anti-HCV therapies. A system dynamic model with 36 cohorts was used to provide maximum flexibility and improved forecasting. New infections incidence of 16,020 (95% confidence interval, 13,510-19,510) was estimated in 2010. HCV viremic prevalence peaked in 1994 at 3.3 (2.8-4.0) million, but it is expected to decline by two-thirds by 2030. The prevalence of more advanced liver disease, however, is expected to increase, as well as the total cost associated with chronic HCV infection. Today, the total cost is estimated at $6.5 ($4.3-$8.4) billion and it will peak in 2024 at $9.1 ($6.4-$13.3) billion. The lifetime cost of an individual infected with HCV in 2011 was estimated at $64,490. However, this cost is significantly higher among individuals with a longer life expectancy.

CONCLUSION

This analysis demonstrates that US HCV prevalence is in decline due to a lower incidence of infections. However, the prevalence of advanced liver disease will continue to increase as well as the corresponding healthcare costs. Lifetime healthcare costs for an HCV-infected person are significantly higher than for noninfected persons. In addition, it is possible to substantially reduce HCV infection through active management. (HEPATOLOGY 2013;57:2164-2170).

摘要

未标注

丙型肝炎病毒(HCV)感染是肝硬化、肝细胞癌和肝移植的主要原因。更好地了解 HCV 疾病进展和相关成本可以帮助医疗界管理 HCV,并根据几种有效的抗 HCV 疗法的出现制定治疗策略。使用具有 36 个队列的系统动力学模型提供了最大的灵活性和改进的预测。2010 年估计新感染发生率为 16020(95%置信区间,13510-19510)。HCV 病毒血症流行率在 1994 年达到峰值,为 330 万(2.8-4.0),但预计到 2030 年将减少三分之二。然而,更严重的肝病流行率预计会增加,与慢性 HCV 感染相关的总成本也会增加。今天,总成本估计为 65 亿美元(43-84 亿美元),并将在 2024 年达到峰值 91 亿美元(64-133 亿美元)。2011 年感染 HCV 的个体的终身成本估计为 64490 美元。然而,在预期寿命较长的个体中,这一成本要高得多。

结论

本分析表明,由于感染率降低,美国 HCV 流行率正在下降。然而,随着晚期肝病的流行率继续上升,相应的医疗保健成本也将继续上升。感染 HCV 的个体的终身医疗保健费用明显高于未感染的个体。此外,通过积极管理可以大大减少 HCV 感染。(HEPATOLOGY 2013;57:2164-2170)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/f4a0dbaa23d3/hep0057-2164-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/d99f1102a158/hep0057-2164-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/54cf359afd07/hep0057-2164-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/387c3f1b4588/hep0057-2164-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/f4a0dbaa23d3/hep0057-2164-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/d99f1102a158/hep0057-2164-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/54cf359afd07/hep0057-2164-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/387c3f1b4588/hep0057-2164-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f25/3763475/f4a0dbaa23d3/hep0057-2164-f4.jpg

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