Hepatitis C: The Juggernaut Rolls on Unchecked

In this issue of The Canadian Journal of Gastroenterology, Myers et al ( pages 381–387) have documented a steady increase in hospital costs associated with the management of chronic hepatitis C. This is a result of an increase in the number of hospitalizations for hepatitis C, increases in in-hospital mortality and increased lengths of stay. They reviewed administrative database information from their local hospital authorities in Calgary. The review was limited to inpatient services and did not capture the increase in costs associated with outpatient services and costs of medication. These data are consistent with the notion that the morbidity associated with hepatitis C is rising. This has been difficult to measure, although there are data suggesting that the mortality from hepatitis C is rising, so it would not be surprising to find increasing morbidity. For example, in 1979, the age-standardized mortality rate related to non-A, non-B hepatitis (mainly hepatitis C) was 0.12 in a population of 100,000, but in 1997 the mortality rate was 0.41 in a population of 100,000 (1).