title: Achieving WHO recommendations for Hepatitis C Virus Elimination in Belgium.
abstract: BACKGROUND
  The World Health Organization (WHO) released updated guidelines for the screening, care and treatment of patients with chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  A previously described HCV disease burden model was used to develop a "WHO scenario" to achieve the WHO recommendations of a 90% reduction in incidence and 65% reduction in liver-related deaths. After determining the steps necessary to achieve this goal, the impact of realistic constraints was modeled.
  
  
  RESULTS
  In 2015, there were 66.200 viremic infections, with 43% diagnosed and 1.350 treated. In order to reduce new infections, treatment must be extended to ≥ F0 patients, including people who inject drugs and other individuals at risk of transmitting HCV. -Additionally, diagnosis and treatment of 3.030 and 4.060 patients, respectively, would be required. The largest attenuation of the WHO scenario would occur if no new cases were diagnosed after 2018 (300% more viremic infections by 2030). Limiting treatment to ≥ F2 patients or treating fewer patients (3.000) would result in 220% or 140% more viremic cases, respectively, compared with the WHO scenario.
  
  
  CONCLUSIONS
  Achieving the WHO guidelines in Belgium requires a coordinated effort to scale up treatment and prevention efforts and to allow treatment access to patients of all fibrosis stages. A scale-up of treatment, however, requires patients to be both diagnosed and linked to care, suggesting a need for increased awareness and expanded screening efforts. Finally, prevention of new HCV infections requires a comprehensive understanding of the population at risk of transmitting HCV.
authors.forename: S
authors.initials: S
authors.lastname: Bourgeois
authors.forename: S
authors.initials: S
authors.lastname: Blach
authors.forename: C
authors.initials: C
authors.lastname: Blach
authors.forename: W
authors.initials: W
authors.lastname: Laleman
authors.forename: C
authors.initials: C
authors.lastname: Matheï
authors.forename: J P
authors.initials: JP
authors.lastname: Mulkay
authors.forename: H
authors.initials: H
authors.lastname: Ravazi
authors.forename: G
authors.initials: G
authors.lastname: Robaeys
authors.forename: P
authors.initials: P
authors.lastname: Stärkel
authors.forename: P
authors.initials: P
authors.lastname: Van Damme
authors.forename: H
authors.initials: H
authors.lastname: Van Vlierberghe
authors.forename: D
authors.initials: D
authors.lastname: Vandijck
authors.forename: C
authors.initials: C
authors.lastname: Vandijck
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001530:Belgium / Q000453:epidemiology; D060740:Disease Eradication / Q000379:methods*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods; D008962:Models, Theoretical; D009026:Mortality; D014944:World Health Organization
chemical_list: D000998:Antiviral Agents