Empirically Calibrated Model of Hepatitis C Virus Infection in the United States

This study presents a comprehensive epidemiologic model of hepatitis C in the United States. Through empirical calibration of model parameter values, the objectives were to gain insights into uncertain aspects of the natural history of hepatitis C and to improve the basis for projecting the future c...

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Bibliographic Details
Published in:American journal of epidemiology 2002-10, Vol.156 (8), p.761-773
Main Authors: Salomon, Joshua A., Weinstein, Milton C., Hammitt, James K., Goldie, Sue J.
Format: Article
Language:English
Subjects:
Adult
and End Results
Biological and medical sciences
Calibration
carcinoma
Carcinoma - etiology
Carcinoma - mortality
Disease Outbreaks
Epidemiologic Studies
Epidemiology
Female
HBsAg
HBV
HCC
HCV
Health Policy
hepatitis B
hepatitis B surface antigen
hepatitis B virus
hepatitis C
Hepatitis C - complications
Hepatitis C - epidemiology
hepatitis C virus
hepatocellular
hepatocellular carcinoma
Human viral diseases
Humans
Infectious diseases
Liver Neoplasms - etiology
Liver Neoplasms - mortality
Male
Medical sciences
Middle Aged
Models, Theoretical
natural history
NHANES III
Policy Making
Prevalence
SEER
Surveillance
Third National Health and Nutrition Examination Survey
United States - epidemiology
Viral diseases
Viral hepatitis
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Description
Summary:This study presents a comprehensive epidemiologic model of hepatitis C in the United States. Through empirical calibration of model parameter values, the objectives were to gain insights into uncertain aspects of the natural history of hepatitis C and to improve the basis for projecting the future course of the epidemic. A systematic review of the published literature was conducted to define plausible ranges around model parameters, and multiple simulations of the model were undertaken using sampled values from these ranges. Model predictions produced by each set of sampled values were compared with available epidemiologic data on infection prevalence and mortality from liver cancer, and various goodness-of-fit criteria were used to identify the range of parameter values that were consistent with these data. The results of the study indicate that rates of progression to advanced liver disease may be lower than previously assumed. The authors also found that a wide range of plausible assumptions about heterogeneity in these rates, beyond that explained by age and sex, is consistent with observed epidemiologic trends. These findings have important implications both for individual clinical decisions and for broader public health policy.
ISSN:0002-9262
1476-6256
0002-9262
DOI:10.1093/aje/kwf100