Estimation of national HCV incidence

The estimation of national HCV incidence proved to be a complex exercise. Using data from the 2008 DHS and other studies, DeWolfe Miller and Abu-Raddad had estimated HCV incidence at 6.9 per 1 000 per year, translating into more than 500 000 new infections per year (DeWolfe Miller F. et al., Proc Natl Acad Sci, 2010). However, their modeling work assumed time-independence, i.e. that age-specific HCV prevalence would be stable over time, ignoring the cohort effect resulting from the initial founding event of the epidemic. By comparing age-specific HCV prevalence of the two national surveys (1996 and 2008), we showed that 2008 estimates were well predicted by a 12-year shift of 1996 estimates, thus confirming the cohort effect (Breban et al., J Viral Hepatitis, 2012; see Figure below, A & B). We proposed an alternative approach to HCV incidence estimation, using data from three village cohorts performed by members of our group (Assiut, Menofia & Qaloubia), leading to a final estimate of 2 per 1 000 per year, or 150 000 new infections per year (see Figure below, C).


Figure HCV incidence


Main conclusion of this study: extrapolating data from incidence measured in three cohort studies, HCV incidence was estimated at 2 per 1 000 per year at national level, translating into 150 000 new infections per year. Of these, an estimated 100 000 will become chronic infections. Repeated measurement of HCV prevalence during 5-year DHS may provide the necessary data for more accurate modeling of national incidence.


Read more: Breban et al., J Viral Hepat, 2012


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