Modelling the elimination of hepatitis C as a public health threat in Iceland: A goal attainable by 2020

Scott, Nick; Ólafsson, Sigurđur; Gottfreðsson, Magnús; Tyrfingsson, Þorarinn; Rúnarsdóttir, Valgerður; Hansdóttir, Ingunn; Hernandez, Ubaldo Benitez; Sigmundsdóttir, Guðrún; Hellard, Margaret

doi:10.1016/j.jhep.2017.12.013

Cited by 54 publications

(45 citation statements)

References 21 publications

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“…The model enabled incorporation of early Australia is in the fortunate position to have a high percentage of the chronic HCV population diagnosed (81%),6 and therefore can achieve HCV elimination targets under stable ongoing HCV screening. A combination of ongoing DAA treatment under the proposed scenarios, with enhanced HCV screening and harm reduction, would be likely to achieve WHO HCV elimination targets (except for the liver-related mortality target) even earlier, as has been demonstrated for modelling of the HCV elimination efforts in Iceland 23. The difficulty in achieving the 65% reduction in liver-related mortality target by 2030 relates to several factors.…”

mentioning

confidence: 88%

Australia on track to achieve WHO HCV elimination targets following rapid initial DAA treatment uptake: A modelling study

Kwon

Dore

Grebely

et al. 2018

Journal of Viral Hepatitis

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Summary Subsidized direct‐acting antiviral (DAA) treatment recently became available to all adults living with chronic hepatitis C virus (HCV) in Australia. Based on rapid uptake (32 600 people initiated DAA in 2016), we estimated the impact on HCV epidemiology and mortality in Australia and determined if Australia can meet the WHO HCV elimination targets by 2030. Using a mathematical model, we simulated pessimistic, intermediate and optimistic DAA treatment scenarios in Australia over 2016‐2030. We assumed treatment and testing rates were initially higher for advanced fibrosis and the same across HCV transmission risk level sub‐populations. We also assumed constant testing rates after 2016. We compared the results to the 2015 level and a counterfactual (IFN‐based) scenario. During 2016‐2030, we estimated an intermediate DAA treatment scenario (2016, 32 600 treated; 2017, 21 370 treated; 2018 17 100 treated; 2019 and beyond, 13 680 treated each year) would avert 40 420 new HCV infections, 13 260 liver‐related deaths (15 320 in viraemic; −2060 in cured) and 10 730 HCC cases, equating to a 53%, 63% and 75% reduction, respectively, compared to the IFN‐based scenario. The model also estimated that Australia will meet the WHO targets of incidence and treatment by 2028. Time to a 65% reduction in liver‐related mortality varied considerably between HCV viraemic only cases (2026) and all cases (2047). Based on a feasible DAA treatment scenario incorporating declining uptake, Australia should meet key WHO HCV elimination targets in 10 to15 years. The pre‐DAA escalation in those with advanced liver disease makes the achievement of the liver‐related mortality target difficult.

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confidence: 88%

Australia on track to achieve WHO HCV elimination targets following rapid initial DAA treatment uptake: A modelling study

Kwon

Dore

Grebely

et al. 2018

Journal of Viral Hepatitis

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“…To achieve overall global eradication, the most suitable way is to progressively eliminate the disease in different areas, with methodology and timing specific for the considered area: a community, a city, an island or an entire state. The work of Scott et al, who investigated with a mathematical model feasibility and timing of HCV elimination in accordance with the WHO elimination target in a restricted area such as Iceland, provides an example of that. The authors proposed to consider Iceland as a model comparable to a large city in other countries and they envisaged four possible scenarios.…”

Section: Eradication and Eliminationmentioning

confidence: 99%

“…38 To achieve overall global eradication, the most suitable way is to progressively eliminate the disease in different areas, with methodology and timing specific for the considered area: a community, a city, an island or an entire state. The work of Scott et al, 39 73 In average, one in four people who acquired HCV through injecting drug use have recently injected drugs, continues to be exposed to the virus and represents an active reservoir. 49 In the USA, based upon the This study caused the blossoming of papers forecasting the number of PWID that must be treated every year in different populations to reach WHO 2030 goals.…”

Section: The C a Sc Ade Of C Arementioning

confidence: 99%

Hepatitis C: Is eradication possible?

Lombardi

Mondelli

2019

Liver International

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Hepatitis C has a relevant global impact in terms of morbidity, mortality and economic costs, with more than 70 million people infected worldwide. In the resolution, “Transforming our world: the 2030 Agenda for Sustainable Development” was included as a focus area in the health‐related goal with world leaders pledging to “combat” it by 2030. In response, WHO drafted the Global Viral Hepatitis Strategy carrying the ambitious targets to reduce the number of deaths by two‐thirds and to increase treatment rates up to 80%. Despite the availability of highly effective therapeutic regimens based on direct‐acting antivirals many barriers to HCV eradication still remain. They are related to awareness of the infection, linkage to care, availability of the therapeutic drug regimens and reinfection. Overall, if an effective prophylactic vaccine will not be available, HCV eradication appears difficult to achieve in the future.

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“…Iceland is an ideal setting to examine the effectiveness of the treatment as prevention approach in a real‐world setting. Results from recent mathematical modelling for Iceland suggest that by intensifying harm reduction, as well as diagnostic and treatment efforts, the WHO targets for HCV elimination could be achieved sooner than 2030, in fact even 6–10 years earlier . This study describes the approach taken to achieve this goal.…”

Section: Introductionmentioning

confidence: 99%

Treatment as Prevention for Hepatitis C (TraP Hep C) – a nationwide elimination programme in Iceland using direct‐acting antiviral agents

Ólafsson

Tyrfingsson²,

Rúnarsdóttir³

et al. 2018

J Intern Med

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Modelling the elimination of hepatitis C as a public health threat in Iceland: A goal attainable by 2020

Cited by 54 publications

References 21 publications

Australia on track to achieve WHO HCV elimination targets following rapid initial DAA treatment uptake: A modelling study

Australia on track to achieve WHO HCV elimination targets following rapid initial DAA treatment uptake: A modelling study

Hepatitis C: Is eradication possible?

Treatment as Prevention for Hepatitis C (TraP Hep C) – a nationwide elimination programme in Iceland using direct‐acting antiviral agents

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