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.
| Original language | English |
|---|---|
| Pages (from-to) | 2190-2198 |
| Journal | Liver International |
| Volume | 38 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2018 |
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Keywords
- chronic infection
- HCV
- linkage to care
- WHO
ASJC Scopus subject areas
- Hepatology
Cite this
Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals? / PITER Collaborating Group.
In: Liver International, Vol. 38, No. 12, 2018, p. 2190-2198.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?
AU - PITER Collaborating Group
AU - Kondili, Loreta A.
AU - Robbins, Sarah
AU - Blach, Sarah
AU - Gamkrelidze, Ivane
AU - Zignego, Anna L.
AU - Brunetto, Maurizia R.
AU - Raimondo, Giovanni
AU - Taliani, Gloria
AU - Iannone, Andrea
AU - Russo, Francesco P.
AU - Santantonio, Teresa A.
AU - Zuin, Massimo
AU - Chessa, Luchino
AU - Blanc, Pierluigi
AU - Puoti, Massimo
AU - Vinci, Maria
AU - Erne, Elke M.
AU - Strazzabosco, Mario
AU - Massari, Marco
AU - Lampertico, Pietro
AU - Rumi, Maria G.
AU - Federico, Alessandro
AU - Orlandini, Alessandra
AU - Ciancio, Alessia
AU - Borgia, Guglielmo
AU - Andreone, Pietro
AU - Caporaso, Nicola
AU - Persico, Marcello
AU - Ieluzzi, Donatella
AU - Madonia, Salvatore
AU - Gori, Andrea
AU - Gasbarrini, Antonio
AU - Coppola, Carmine
AU - Brancaccio, Giuseppina
AU - Andriulli, Angelo
AU - Quaranta, Maria G.
AU - Montilla, Simona
AU - Razavi, Homie
AU - Melazzini, Mario
AU - Vella, Stefano
AU - Craxì, Antonio
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - chronic infection
KW - HCV
KW - linkage to care
KW - WHO
UR - http://www.scopus.com/inward/record.url?scp=85052599351&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052599351&partnerID=8YFLogxK
U2 - 10.1111/liv.13901
DO - 10.1111/liv.13901
M3 - Article
AN - SCOPUS:85052599351
VL - 38
SP - 2190
EP - 2198
JO - Liver International
JF - Liver International
SN - 1478-3223
IS - 12
ER -