title: Chronic hepatitis C virus (HCV) burden in Rhode Island: modelling treatment scale-up and elimination.
abstract: We utilized a disease progression model to predict the number of viraemic infections, cirrhotic cases, and liver-related deaths in the state of Rhode Island (RI) under four treatment scenarios: (1) current HCV treatment paradigm (about 215 patients treated annually, Medicaid reimbursement criteria fibrosis stage ⩾F3); (2) immediate scale-up of treatment (to 430 annually) and less restrictive Medicaid reimbursement criteria (fibrosis stage ⩾F2); (3) immediate treatment scale-up and no fibrosis stage-specific Medicaid reimbursement criteria (⩾F0); (4) an 'elimination' scenario (i.e. a continued treatment scale-up needed to achieve >90% reduction in viraemic cases by 2030). Under current treatment models, the number of cirrhotic cases and liver-related deaths will plateau and peak by 2030, respectively. Treatment scale-up with ⩾F2 and ⩾F0 fibrosis stage treatment criteria could reduce the number of cirrhotic cases by 21·7% and 10·0%, and the number of liver-related deaths by 19·3% and 7·4%, respectively by 2030. To achieve a >90% reduction in viraemic cases by 2030, over 2000 persons will need to be treated annually by 2020. This strategy could reduce cirrhosis cases and liver-related deaths by 78·9% and 72·4%, respectively by 2030. Increased HCV treatment uptake is needed to substantially reduce the burden of HCV by 2030 in Rhode Island.
authors: Department of Epidemiology,Brown University School of Public Health,Providence,RI,USA.
authors: A I
authors: AI
authors: Soipe
authors: Center for Disease Analysis,Lafayette,CO,USA.
authors: H
authors: H
authors: Razavi
authors: Center for Disease Analysis,Lafayette,CO,USA.
authors: D
authors: D
authors: Razavi-Shearer
authors: Department of Health Services Policy and Practice,Brown University School of Public Health,Providence,RI,USA.
authors: O
authors: O
authors: Galárraga
authors: Division of Infectious Diseases,The Warren Alpert Medical School of Brown University, andThe Miriam Hospital,Center for AIDS Research (CFAR) Providence,RI,USA.
authors: L E
authors: LE
authors: Taylor
authors: Department of Epidemiology,Brown University School of Public Health,Providence,RI,USA.
authors: B D L
authors: BDL
authors: Marshall
keywords: Disease burden; HCV; epidemiology; hepatitis C; modelling; treatment