title: Impact of improved treatment on disease burden of chronic hepatitis C in New Zealand.
abstract: BACKGROUND
  We describe the burden of HCV infection and estimate the effect of four different treatment strategies to reduce HCV-related morbidity and mortality.
  
  
  METHODS
  Baseline model parameters were based upon literature review and expert consensus, focusing on New Zealand data. Four scenarios were modelled: Scenario 1 estimated the impact of increased treatment efficacy, while Scenario 2 estimated the effect of increased treatment efficacy and gradual increases in numbers treated. Scenarios 3 and 4 estimated the impact of deferred introduction of new DAAs for either 1 or 2 years.
  
  
  RESULTS
  Prevalence of HCV infection peaked in 2010 (50,480 cases). Peak prevalence of cirrhosis and HCC will occur after 2030. Scenario 2 resulted in sizeable decreases in HCV-related morbidity and mortality. The impact of Scenario 1 was smaller. Deferring funding for new DAA treatments for a further 1 or 2 years resulted in an 18-36% increase in liver-related deaths in 2030.
  
  
  CONCLUSIONS
  While prevalence of chronic HCV infection may have peaked, disease burden continues to grow. Increased treatment uptake and efficacy combined with efforts to reduce disease transmission, will help prevent advanced liver disease and deaths.
authors.affiliation: New Zealand Liver Transplant Unit, 15th Floor Support Building, Auckland City Hospital, Grafton, Auckland, New Zealand. edgane@adhb.govt.nz.
authors.forename: Edward
authors.initials: E
authors.lastname: Gane
authors.forename: Catherine
authors.initials: C
authors.lastname: Stedman
authors.forename: Cheryl
authors.initials: C
authors.lastname: Brunton
authors.forename: Sarah
authors.initials: S
authors.lastname: Radke
authors.forename: Charles
authors.initials: C
authors.lastname: Henderson
authors.forename: Chris
authors.initials: C
authors.lastname: Estes
authors.forename: Homie
authors.initials: H
authors.lastname: Razavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000453:epidemiology; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D015897:Comorbidity; D017281:Cost of Illness; D016503:Drug Delivery Systems; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011480:Protease Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011480:Protease Inhibitors