Scaling up prevention and treatment towards the elimination of hepatitis C: A global mathematical model
The Lancet Apr 03, 2019
Heffernan A, et al. - Researchers, for the first time, assessed the impact of public health interventions on the global hepatitis C virus (HCV) epidemic and investigated whether the World Health Organization’s (WHO) elimination targets could be met. For this analysis, they developed a dynamic transmission model of the global HCV epidemic, calibrated to 190 countries, which included data on demography, people who inject drugs (PWID), current coverage of treatment and prevention programs, a natural history of the disease, prevalence of HCV, and HCV-attributable mortality. They found that interventions that reduce the risk of transmission by 80% in the non-PWID population and increase the coverage of harm reduction services to 40% of PWID could prevent 14.1 million new infections by 2030. The data presented in this work showed a comprehensive package of prevention, screening, and treatment interventions could avert 15.1 million new infections and 1.5 million cirrhosis- and liver cancer-related deaths, corresponding to an 81% reduction in incidence and a 61% reduction in mortality vs 2015 baseline. This would achieve the WHO HCV incidence reduction target of 80% but is just below the 65% mortality target, which could be achieved by 2032. In order to reduce the burden of HCV, further improvements in blood safety and infection control, expansion or creation of PWID harm reduction services, and extensive HCV screening with concomitant treatment for all are needed. These findings should inform the ongoing global action aimed at eliminating the HCV epidemic.
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