Feasibility of Hepatitis C Elimination in China: From Epidemiology, Natural History, and Intervention Perspectives

Zhao, Zeyu; Chu, Meijie; Guo, Yichao; Yang, Shiting; Abudurusuli, Guzainuer; Frutos, Roger; Chen, Tianmu

doi:10.3389/fmicb.2022.884598

Cited by 12 publications

(6 citation statements)

References 74 publications

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“…37 In addition, strict screening of blood donors and, prevention measures targeting broken skin-mucous membrane transmission, sexual transmission and mother-to-child transmission have been employed to prevent HCV infection. 38 The highest HCV ASIRs were observed in some African countries, such as Egypt and Angola, largely because of the lack of prevention strategies, such as the disposal of used needles and syringes. 39,40 In contrast to other hepatitis types, there HCV has no effective vaccine.…”

Section: Discussionmentioning

confidence: 99%

Incidence trends of acute viral hepatitis caused by four viral etiologies between 1990 and 2019 at the global, regional and national levels

Ouyang¹,

Pan²,

Guan³

et al. 2022

Liver International

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Background Hepatitis is a major public health challenge and a leading cause of death worldwide. We aimed to study the cause‐specific incidence and temporal trends of acute viral hepatitis (AVH). Methods Data on AVH etiologies were available from the Global Burden of Disease study 2019. Estimated annual percentage change (EAPC) was used to quantify temporal trend in AVH age‐standardized incidence rates (ASIRs) by region, sex and aetiology. Results From 1990 to 2019, the global incidence of AVH increased by 8.02%, from 244 350 063 in 1990 to 263 951 645 in 2019, with an average decreasing ASIR of 0.52% (95% CI −0.58% to −0.45%) annually. The ASIR of AVH due to hepatitis B virus (HBV) decreased, while those of hepatitis A (HAV), hepatitis C (HCV) and hepatitis E (HEV) remained stable, with EAPCs (95% CI) of −1.47 (−1.58 to −1.36), 0 (−0.09 to 0.09), −0.35 (−0.83 to −0.13), and −0.16 (−0.41 to 0.09) respectively. Although the number of new AVH cases increased in the low sociodemographic index (SDI), low‐middle SDI regions, the ASIRs decreased in all five SDI regions. Globally, HAV and HBV are the leading causes of acute hepatitis. The EAPC is significantly associated with a baseline ASIR of less than 5500 per 100 000 population (ρ = −0.44), and with the 2019 human development index (HDI) (ρ = 0.16) for AVH. Conclusions Although the ASIR of AVH showed a generally decreasing trend, the burden of AVH remains a major public health challenge globally. The findings may be helpful for policymakers in establishing appropriate policies to reduce the viral hepatitis burden.

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Section: Discussionmentioning

confidence: 99%

Incidence trends of acute viral hepatitis caused by four viral etiologies between 1990 and 2019 at the global, regional and national levels

Ouyang¹,

Pan²,

Guan³

et al. 2022

Liver International

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“…The CHC prevalence corresponded to anti-HCV prevalence, taking into account a 30% spontaneous clearance rate. 29 It was assumed that individuals are initially screened for anti-HCV, and if found positive, they undergo HCV RNA confirmatory testing. The sensitivity and specificity of testing anti-HCV were 98.1% and 99.8%, respectively.…”

Section: Methodsmentioning

confidence: 99%

Universal screening for HCV infection in China: An effectiveness and cost-effectiveness analysis

Zhou,

Yan,

Che

et al. 2024

JHEP Reports

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“…Furthermore, hepatitis C is transmitted through various routes. While nosocomial transmission is now effectively controlled, the challenges persist in controlling transmission among individuals engaged in drug use and those involved in high-risk sexual behaviors [ 11 , 12 ]. The majority of this population is infected with subtypes 3 and 6 [ 13 – 15 ], signifying that patients with genotype 3b will account for an increased proportion of patients with hepatitis C in the future [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Is it time for China to prioritize pan-genotypic regimens for treating patients with hepatitis C?

Tu,

Tang,

Zhou

et al. 2024

Cost Eff Resour Alloc

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Introduction The treatment of hepatitis C has entered the pan-genotypic era, but the effectiveness is not good for the genotype 3b patients who have a large proportion in China. The guidelines for hepatitis C recommend the use of gene-specific regimens when the regional 3b prevalence rate greater than 5%. This study is to explore rationality of this proportion and the cost-effectiveness to implement pan-genotypic regimens in China. Methods A decision Markov model was developed from the health system perspective to evaluate the effectiveness and cost-effectiveness between pan-genotypic and gene-specific treatment regimens for hepatitis C patients. Additionally, we set a regional genotype 3b patient proportion of 0–100% to explore at which proportion it is necessary to perform genotype identification and typing therapy on patients. Model parameters were derived from published literature and public databases. Effectiveness was measured by cured patient numbers, newly diagnosed cases of decompensated cirrhosis, hepatocellular carcinoma, need for liver transplantation, and quality-adjusted life years (QALYs). Cost-effectiveness outcomes included costs and the incremental cost-effectiveness ratio (ICER). The 1–3 times 2022 Chinese per capita gross domestic product was used as the willingness-to-pay threshold. One-way and probabilistic sensitivity analyses were performed to assess the uncertainty of the model parameters. Results Compared with gene-specific regimens, pan-genotypic regimens resulted in an additional 0.13 QALYs and an incremental cost of $165, the ICER was $1,268/QALY. From the view of efficacy, the pan-genotypic regimens cured 5,868 more people per 100,000 patients than gene-specific regimens, avoiding 86.5% of DC cases, 64.6% of HCC cases, and 78.2% of liver transplant needs. Identifying 3b patients before treatment was definitely cost-effectiveness when their prevalence was 12% or higher. The results remained robust in sensitivity analyses. Conclusions In China, the prioritized recommendation of pan-genotypic therapeutics proves to be both cost-effective and efficacious. But, in regions where the prevalence of genotype 3b exceeds 12%, it is necessary to identify them to provision of more suitable therapies.

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Feasibility of Hepatitis C Elimination in China: From Epidemiology, Natural History, and Intervention Perspectives

Cited by 12 publications

References 74 publications

Incidence trends of acute viral hepatitis caused by four viral etiologies between 1990 and 2019 at the global, regional and national levels

Incidence trends of acute viral hepatitis caused by four viral etiologies between 1990 and 2019 at the global, regional and national levels

Universal screening for HCV infection in China: An effectiveness and cost-effectiveness analysis

Is it time for China to prioritize pan-genotypic regimens for treating patients with hepatitis C?

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