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Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study
- Source :
- Krarup, H & European Union HCV Collaborators 2017, ' Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030 : a modelling study ', The Lancet Gastroenterology & Hepatology, vol. 2, no. 5, pp. 325-336 . https://doi.org/10.1016/S2468-1253(17)30045-6, Lancet Gastroenterology & Hepatology, 2(5), 325-336. Elsevier Ltd., The Lancet Gastroenterology & Hepatology, Vol. 2, No 5 (2017) pp. 325-336, Lancet gastroenterology & hepatology, The lancet. Gastroenterology & hepatology, 2(5), 325-336. HANLEY & BELFUS-ELSEVIER INC, Øvrehus, A L H & European Union HCV Collaborators 2017, ' Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030 : a modelling study ', The Lancet Gastroenterology & Hepatology, vol. 2, no. 5, pp. 325-336 . https://doi.org/10.1016/S2468-1253(17)30045-6
- Publication Year :
- 2017
-
Abstract
- Background Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality worldwide. In the European Union (EU), treatment and cure of HCV with direct-acting antiviral therapies began in 2014. WHO targets are to achieve a 65% reduction in liver-related deaths, a 90% reduction of new viral hepatitis infections, and 90% of patients with viral hepatitis infections being diagnosed by 2030. This study assessed the prevalence of HCV in the EU and the level of intervention required to achieve WHO targets for HCV elimination. Methods We populated country Markov models for the 28 EU countries through a literature search of PubMed and Embase between Jan 1, 2000, and March 31, 2016, and a Delphi process to gain expert consensus and validate inputs. We aggregated country models to create a regional EU model. We used the EU model to forecast HCV disease progression (considering the effect of immigration) and developed a strategy to acehive WHO targets. We used weighted average sustained viral response rates and fibrosis restrictions to model the effect of current therapeutic guidelines. We used the EU model to forecast HCV disease progression (considering the effect of immigration) under current screening and therapeutic guidelines. Additionally, we back-calculated the total number of patients needing to be screened and treated to achieve WHO targets. Findings We estimated the number of viraemic HCV infections in 2015 to be 3â238â000 (95% uncertainty interval [UI] 2â106â000â3â795â000) of a total population of 509â868â000 in the EU, equating to a prevalence of viraemic HCV of 0·64% (95% UI 0·41â0·74). We estimated that 1â180â000 (95% UI 1â003â000â1â357â000) people were diagnosed with viraemia (36·4%), 150â000 (12â000â180â000) were treated (4·6% of the total infected population or 12·7% of the diagnosed population), 133â000 (106â000â160â000) were cured (4·1%), and 57â900 (43â900â67â300) were newly infected (1·8%) in 2015. Additionally, 30â400 (26â600â42â500) HCV-positive immigrants entered the EU. To achieve WHO targets, unrestricted treatment needs to increase from 150â000 patients in 2015 to 187â000 patients in 2025 and diagnosis needs to increase from 88â800 new cases annually in 2015 to 180â000 in 2025. Interpretation Given its advanced health-care infrastructure, the EU is uniquely poised to eliminate HCV; however, expansion of screening programmes is essential to increase treatment to achieve the WHO targets. A united effort, grounded in sound epidemiological evidence, will also be necessary. Funding Gilead Sciences.
- Subjects :
- Pediatrics
ddc:616.07
medicine.disease_cause
0302 clinical medicine
Cost of Illness
Epidemiology
Prevalence
EPIDEMIOLOGY
030212 general & internal medicine
Settore SECS-P/01 - Economia Politica
CIRRHOSIS
media_common
ddc:616
Antiviral Agents/therapeutic use
education.field_of_study
INJECT DRUGS
Gastroenterology
HCV INFECTION
virus diseases
Hepatitis C
Emigration and Immigration
DISEASE BURDEN
Markov Chains
Emigration and Immigration/statistics & numerical data
030211 gastroenterology & hepatology
Viral hepatitis
Modelling
Eradication
European Union
prevalence
COUNTRIES
medicine.medical_specialty
Hepatitis C virus
Population
UNITED-STATES
World Health Organization
Antiviral Agents
03 medical and health sciences
SDG 3 - Good Health and Well-being
PEOPLE
Internal medicine
Intervention (counseling)
medicine
Journal Article
media_common.cataloged_instance
Humans
Viremia
European union
Disease Eradication
education
Hepatitis C/diagnosis/drug therapy/epidemiology/prevention & control
Hepatology
business.industry
Viremia/diagnosis/drug therapy/epidemiology/prevention & control
medicine.disease
Virology
PREVENTION
digestive system diseases
Human medicine
VIRAL-HEPATITIS
business
Subjects
Details
- ISSN :
- 24681253
- Volume :
- 2
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Lancet Gastroenterology & Hepatology
- Accession number :
- edsair.doi.dedup.....6167fe45cfcadfaa8e9dc89df3a54984