Costs of Hepatitis C

Abstract

THE HEPATITIS C virus (HCV) was identified in 1988 and has received increasing attention from physicians and researchers ever since. Because HCV has only been recently identified, national statistics are difficult to obtain. Initial estimates suggested that the annual mortality due to chronic liver disease (CLD) from HCV was between 8000 and 10 000.¹ Recent work² has assumed 8000 to be the more reasonable estimate. An initial estimate of the prevalence of HCV based on the anti-HCV antibody was 3.9 million persons.³ However, more recently, Alter et al⁴ estimate the prevalence of active HCV infection at 2.7 million persons. Whereas the incidence of the disease has been decreasing, the overall prevalence is large, roughly 4 times as large as that of the human immunodeficiency virus.⁵ Sixty-five percent of persons with an HCV infection are aged 30 to 49 years. The highest rates of new infections are among persons aged 20 to 39 years.⁶ It is the single most common reason for liver transplantations in the United States.⁵ Risk factors include sharing of contaminated needles by drug users, multiple sex partners, employment as a health care worker, receipt of a blood transfusion any time before 1988, and, more generally, poverty, low educational attainment, and having been divorced or separated.⁴