Cohort Profile: the Swiss Hepatitis C Cohort Study (SCCS).

The hepatitis C virus, formerly classified as ‘non-A non-B’ hepatitis virus, was identified in 1989. This blood-borne virus is endemic worldwide, with an estimated 170 million persons chronically infected, representing approximately 3% of the world population. Long-term morbidity associated with persistent hepatitis C virus infection includes the development of cirrhosis and primary liver cancer. The Swiss Hepatitis C Cohort Study (SCCS) is a joint effort between the Swiss Group of Experts in Viral Hepatitis and the Swiss Association for the Study of the Liver. The SCCS was established because large population-based cohort studies are the only way to confirm or refute working hypotheses on the natural course of chronic hepatitis C and on hepatitis C virus pathology, and partly because experience with a similar collaborative effort of specialized treatment centres had already been successfully established for a human immunodeficiency virus cohort in Switzerland. Therefore, the aims of the SCCS were to set up an infrastructure and investigative network fostering clinical and biomedical research on the natural history of hepatitis C virus infection and to optimize and standardize the management and treatment of hepatitis C virus-infected patients. The cohort is expected to add information on factors that shape progression of hepatitis C virus infection, thus informing future therapeutic decisions and predictions of the burden of hepatitis C virus-related diseases at the population level, as well as supplementing epidemiological data collected by the mandatory national surveillance system at the Swiss Federal Office of Public Health. Ethical approval for data collection was obtained from each hospital’s ethics committee. Recruitment for the SCCS began in September 2000, with initial funding from the Swiss Group of Experts in Viral Hepatitis. Since April 2001, funding of the core structure has been largely provided by the Swiss National Science Foundation. Additional sources of funding, for both the core structure and the scientific nested projects, have been provided over the years by several public and private institutions, including the Swiss Office for Education and Science and the European Commission.