HCV disease burden and population segments in Switzerland

Abstract

Background Switzerland has made strides towards hepatitis C virus elimination, but as of 2019, elimination was not guaranteed. However, political interest in viral hepatitis has been increasing. We sought to develop a better understanding of Switzerland's progress towards HCV elimination and the profile of remaining HCV‐RNA‐positive patients. Methods A previously described Markov model was updated with recent diagnosis and treatment data and run to generate new forecasts for HCV disease burden. Two scenarios were developed to evaluate HCV morbidity and mortality under the status quo and a scenario that achieves the Swiss Hepatitis Strategy Elimination targets. Next, an analysis was conducted to identify population segments bearing a high burden of disease, where future elimination efforts could be directed. Results At the beginning of 2020, an estimated 32 100 viremic infections remained in Switzerland (0.37% viremic prevalence). Adult (≥18 years of age) permanent residents born abroad represented the largest subpopulation, accounting for 56% of HCV infections. Thirteen countries accounted for ≥60% of viremic infections amongst permanent residents born abroad, with most people currently residing in Zurich, Vaud, Geneva, Bern, Aargau and Ticino. Amongst Swiss‐born HCV‐RNA‐positive persons, two‐thirds had a history of IDU, corresponding to 33% of total infections. Conclusions In Switzerland, extra efforts for diagnosis and linkage to care are warranted in foreign‐born populations and people with a history of drug use. Population‐level measures (eg increasing the number of providers, increase screening) can identify patients who may have otherwise fallen through the gaps or avoided care because of stigma.

Hépatite B et C: une mise à jour sur lʼhépatite virale chronique

“…En suisse, la prévalence de l'hépatite C est estimée à 0.37 % [22], ce qui est relativement faible à comparer avec certains chiffres de pays européens ou africains [23]. Cependant, le dépistage systématique du VHC n' est pas recommandé en suisse, hormis pour les personnes à haut risque d'infection, par exemple les usagers de drogues intraveineuse ou intranasale, pour lesquels un dépistage annuel est recommandé.…”

Scaling-up hepatitis C screening and treatment in Swiss outpatient psychiatric settings: A cost-effectiveness analysis

“…The HCV prevalence estimates derived from recorded diagnoses are lower than the previous study, likely because the overall HCV prevalence in Switzerland is lower than in international areas such as Geneva (>40% foreign population). (10,11) Further, cases may not have been recorded or identified in our analysis of diagnoses data. Therefore, the HCV prevalence estimates may be underestimated, enabling a conservative cost-effectiveness analysis.…”

Hausärztinnen und Hausärzte dürfen neu Hepatitis-C-Behandlungen selbst verschreiben

“…Von den 2021 geschätzten 32 000 Personen in der Schweiz mit einer chronischen Hepatitis C sind 40% nicht getestet [2]. Im Schnitt bedeutet dies, dass in je- Mit den heute verfügbaren Kombinationspräparaten können mehr als 95% der Behandelten geheilt werden.…”