6533b7d2fe1ef96bd125ecb3
RESEARCH PRODUCT
Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?
La KondiliS RobbinsS BlachI GamkrelidzeAl ZignegoMr BrunettoG RaimondoG TalianiA IannoneFp RussoTa SantantonioM ZuinL ChessaP BlancM PuotiM VinciEm ErneM StrazzaboscoM MassariP LamperticoMg RumiA FedericoA OrlandiniA CiancioG BorgiaP AndreoneN CaporasoM PersicoD IeluzziS MadoniaA GoriA GasbarriniC CoppolaG BrancaccioA AndriulliMg QuarantaS MontillaH RazaviM MelazziniS VellaA CraxìGroup. Piter Collaboratingsubject
HCV; WHO; chronic infection; linkage to careLiver Cirrhosismedicine.medical_specialtyCarcinoma HepatocellularSustained Virologic ResponseViral HepatitisSettore MED/12 - GASTROENTEROLOGIAWorld Health OrganizationAntiviral AgentsNO03 medical and health sciencesLiver diseaseWHO0302 clinical medicinePharmacotherapyCost of IllnessCause of DeathHealth caremedicineHumans030212 general & internal medicineViremiachronic infection HCV linkage to care WHODisease EradicationMortalityIntensive care medicineCause of deathlinkage to carechronic infection; HCV; linkage to care; WHODisease EradicationHepatologybusiness.industryPublic healthCarcinomaLiver NeoplasmsHepatocellularHepatitis Cmedicine.diseasechronic infectionHepatitis CMarkov Chainschronic infection; HCV; linkage to care; WHO; Antiviral Agents; Carcinoma Hepatocellular; Cost of Illness; Disease Eradication; Hepatitis C; Humans; Italy; Liver Cirrhosis; Liver Neoplasms; Markov Chains; Mortality; Sustained Virologic Response; Viremia; World Health Organization; Cause of DeathItalychronic infection;HCV;linkage to care;WHOHCVchronic infection; HCV; linkage to care; WHO; Hepatology030211 gastroenterology & hepatologybusinessViral hepatitisdescription
Abstract Background & Aims Advances in direct‐acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked‐to‐care individuals on overall HCV burden estimates and identified a possible strategy to achieve the WHO targets by 2030. Methods Using a modelling approach grounded in Italian real‐life data of diagnosed and treated patients, different linkage‐to‐care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals. Results Under the 40% linked‐to‐care scenario, viraemic burden would decline (60%); however, eligible patients to treat will be depleted by 2025. Increased case finding through a targeted screening strategy in 1948‐1978 birth cohorts could supplement the pool of diagnosed patients by finding 75% of F0‐F3 cases. Under the 60% linked‐to‐care scenario, viraemic infections would decline by 70% by 2030 but the patients eligible for treatment will run out by 2028. If treatment is to be maintained, a screening strategy focusing on 1958‐1978 birth cohorts could capture 55% of F0‐F3 individuals. Under the 80% linked‐to‐care scenario, screening limited in 1968‐1978 birth cohorts could sustain treatment at levels required to achieve the HCV elimination goals. Conclusion In Italy, which is an HCV endemic country, the eligible pool of patients to treat will run out between 2025 and 2028. To maintain the treatment rate and achieve the HCV elimination goals, increased case finding in targeted, high prevalence groups is required.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |