Strategies to manage hepatitis C virus (HCV) disease burden.
The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. The largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
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Wedemeyer
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Duberg
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Buti
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Rosenberg
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Frankova
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Esmat
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Örmeci
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Van Vlierberghe
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Gschwantler
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Akarca
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Aleman
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Balık
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Berg
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Blasco
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Brandão Mello
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Bruggmann
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Christensen
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Clausen
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Coelho
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Cornberg
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Dore
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El-Sayed
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Ergör
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Estes
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Falconer
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Félix
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Ferraz
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Ferreira
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García-Samaniego
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Gerstoft
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Giria
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Gonçales
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Guimarães Pessôa
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Hézode
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Hindman
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Hofer
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Husa
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Idilman
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Kåberg
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Kaita
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Kautz
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Kaymakoglu
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Krajden
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Krarup
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Laleman
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Lavanchy
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Lázaro
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Marinho
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Mauss
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Mendes Correa
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Moreno
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Müllhaupt
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Myers
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Nemecek
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Parkes
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Peltekian
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Ramji
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Razavi
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Roberts
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Roudot-Thoraval
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Ryder
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Sarmento-Castro
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Sarrazin
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Semela
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Sherman
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Shiha
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Sperl
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Stärkel
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Stauber
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Thompson
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Urbanek
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Van Damme
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van Thiel
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Vandijck
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Vogel
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Waked
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Weis
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Wiegand
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Yosry
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Zekry
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Negro
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Sievert
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Gower
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D060740:Disease Eradication; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D014943:Global Health; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D055815:Young Adult
D000998:Antiviral Agents
HCV; diagnosis; disease burden; epidemiology; hepatitis C; incidence; mortality; prevalence; scenarios; treatment