OBJECTIVES: To identify and understand hepatitis C virus (HCV) prevalence and mortality rates, disease course, and the availability of data on patient and viral characteristics that may affect treatment and outcomes.
METHODS: A targeted review was undertaken in MEDLINE, using a predefined search strategy, to identify studies describing HCV burden. Additional searches were performed on the ISPOR conference and key epidemiological websites.
RESULTS: A total of 1,773 references were identified. Results indicated that global HCV prevalence increased from 2.3% to 2.8% between 1990 and 2005, with highest prevalence in East Asia (> 3.5%). HCV screening programmes and mandatory reporting are present in only a few countries, so prevalence is likely to be even greater. In 2010, there were estimated to be 499,000 deaths globally related to HCV, making HCV-related complications the 25th most common cause of death and a significant global health problem. The prevalence of HCV genotypes varies geographically. Genotype 1 is most prevalent in North and South America, Europe, and the Asia-Pacific region (~45%-80%). Genotype 3 is most prevalent in South Asia (Pakistan, India, and Thailand) (~52%-80%); genotype 4 is most prevalent in the Middle East (~60%-92%). There is a lack of data for the majority of African and some Middle Eastern countries. Genotype 1 is associated with increased insulin resistance, worse response to therapy, and higher risk of developing cirrhosis and hepatocellular carcinoma. Genotype 3 is associated with increased steatosis (up to 73% of patients vs. 51% in patients with other genotypes) and fibrosis.
CONCLUSIONS: In light of upcoming treatment alternatives, detailed epidemiological studies will help ascertain more accurately the prevalence of each HCV genotype, so that the true burden of HCV can be understood and treatments targeted appropriately.
