Journal of Hepatology
Volume 49, Issue 2 , Pages 175-183, August 2008

Impact of viral eradication on mortality related to hepatitis C: A modeling approach in France

  • Sylvie Deuffic-Burban

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • LEM-CNRS, Université Catholique de Lille, 41 rue du Port, Lille 59046, France
    • Corresponding Author InformationCorresponding author. Tel.: +33 3 20 13 40 62; fax: +33 3 20 13 40 70.
  • ,
  • Pierre Deltenre

      Affiliations

    • Service d’Hépato-Gastroentérologie, Hôpital de Jolimont, Haine-Saint-Paul, Belgium
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Alexandre Louvet

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Valérie Canva

      Affiliations

    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Sebastien Dharancy

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Antoine Hollebecque

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Jeanne Boitard

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France
  • ,
  • Jean Henrion

      Affiliations

    • Service d’Hépato-Gastroentérologie, Hôpital de Jolimont, Haine-Saint-Paul, Belgium
  • ,
  • Yazdan Yazdanpanah

      Affiliations

    • LEM-CNRS, Université Catholique de Lille, 41 rue du Port, Lille 59046, France
    • Service des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, Tourcoing, France
    • EA 2694, Faculté de Médecine de Lille, Lille, France
  • ,
  • Philippe Mathurin

      Affiliations

    • CTRS-INSERM U795, CHRU Lille, Lille, France
    • Service d’Hépato-Gastroentérologie, Hôpital Huriez, CHRU Lille, Lille, France

Received 10 September 2007; received in revised form 26 March 2008; accepted 14 April 2008. published online 21 May 2008.

Associate Editor: J.G. McHutchison

Background/Aims

In France, two recent studies enabled modeling of the impact of viral eradication on HCV mortality.

Methods

The French HCV population was simulated from infection to death using a computer-based model. We took into account the impact of alcohol, present screening and antiviral therapy to predict 2006–2025 HCV mortality and to assess the impact of viral eradication.

Results

In 2006, the model estimated that among HCV-RNA+, 55% were F0–F1, 18% F2, 22% F3–F4 and 6% had liver complications. The mortality ratio was 11-fold higher in alcoholic patients 40–65 years old. Current therapy will save 14,400 (95% CI, 13,900–15,000) lives compared to absence of therapy. Sensitivity analyses did not change the main results. Contrary to guidelines, if patients F<2 were treated in the same proportions as those with F2, 700 (95% CI, 700–750) lives would be saved. If screening were to reach 75% in 2010, 4 years earlier than model expectation, 950 (95% CI, 900–1000) lives would be saved. If a new molecule improving eradication for genotype 1/4 by 40% were to become available in 2010, 1500 (95% CI, 1400–1600) lives would be saved.

Conclusions

Current therapy is reducing HCV mortality. Therapeutic guidelines must take into account their impact on HCV mortality.

Keywords: Alcohol, Antiviral therapy, Back-calculation, HCV eradication, Hepatocellular carcinoma, Liver disease, Markov model, Screening

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 Dr. Deuffic-Burban received an unrestricted grant from Roche Laboratories, France to conduct this study. The other authors do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript.

PII: S0168-8278(08)00294-8

doi:10.1016/j.jhep.2008.04.012

Journal of Hepatology
Volume 49, Issue 2 , Pages 175-183, August 2008