Abstract
Background/Aims: In France, the prevalence of hepatitis C virus (HCV) exceeds that of HIV, but in
the absence of treatment, HIV infection progresses more rapidly than HCV. More HIV-infected
patients, however, have received treatment. Using reported public health data in France
and natural history models, we applied the back-calculation method to project future
mortality from HCV and HIV incorporating current therapies.
Methods: The HCV model was based on literature data for the natural history of HCV and reports
of hepatocellular carcinoma mortality. The HIV model used estimates from the French
Hospital Database on HIV and reported AIDS cases and deaths.
Results: Peak annual mortality from HIV at 5000 occurred in 1994 and was 1000 in 1998, but
HCV mortality likely increased through the 1990s and reached 3000 in 1998. Considering
only HCV infections occurring until 1998 and currently available therapy, our model
suggested that annual HCV-related mortality would continue to rise and would reach
4500 deaths in 2022. In contrast, AIDS-related deaths began to decrease in 1997.
Conclusions: The public health burden of HCV is likely on the rise, while the burden of HIV,
given the fairly widespread use of effective medications, may be on the decline. These
results may help health policymakers in planning their responses to these epidemics.
Keywords
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Article info
Publication history
Accepted:
October 22,
2003
Received in revised form:
September 26,
2003
Received:
March 21,
2003
See Editorial, pages x–yIdentification
Copyright
© 2003 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
