Hepatitis C virus associated morbidity and mortality in New York State: The current and future burden

Background: Hepatitis C virus (HCV), the most common chronic blood-borne infection in the United States, can lead to decompensated cirrhosis, hepatocellular carcinoma, liver failure and death. No comprehensive assessment of the morbidity and mortality in New York State (NYS) has been done to examine both the current and future burden. The aim of this study was to assess current-, and predict future morbidity and mortality in NYS. Methods: Reported HCV-morbidity and mortality from 2003 to 2008 were obtained using the NYS cancer registry, hospital discharge data and multiple cause of death files. Using Markov modeling and the natural history model, projections of the estimated number of persons living in NYS with HCV were calculated through 2050 based upon a previously calculated NYS incidence estimate. Projections were also calculated assuming treating varying proportions of treatment eligible cases. Results: Between 2003 and 2008, reported morbidity and mortality was higher among males and those over the age of 40. The future projections estimated a higher burden than reported in NYS data sources with an increase for at least eight years. Actively treating one quarter of eligible cases reduced the projected caseload burden by roughly 50 percent in less than four decades. Conclusions: The burden reported in NYS suggests only a small percentage of cases with advanced disease have been linked to care. Taking into consideration that not all cases are diagnosed, identification and treatment of cases can impact the epidemic in NYS.