Strategies to manage hepatitis <scp>C</scp> virus (<scp>HCV</scp>) disease burden

Wedemeyer, Heiner; Duberg, Ann‐Sofi; Buti, María; Rosenberg, William; Fraňková, Soňa; Esmat, Gamal; Örmeci, Necati; Vlierberghe, Hans Van; Gschwantler, Michael; Akarca, Ulus Salih; Aleman, Soo; Balık, İsmail; Berg, Thomas; Bihl, Florian; Bilodeau, Marc; Blasco, Antonio Javier; Mello, Carlos Eduardo Brandão; Bruggmann, Philip; Calinas, Filipe; Calleja, José Luís; Cheinquer, Hugo; Christensen, Peer Brehm; Clausen, Mette Rye; Coelho, Henrique Sérgio Moraes; Cornberg, Markus; Cramp, Matthew; Dore, Gregory J.; Doss, Wahid; El-Sayed, Manal Hamdy; Ergör, Gül; Estes, Chris; Falconer, Karolin; Felix, Janaína Cardoso; Ferraz, Maria Lúcia Gomes; Ferreira, Paulo Roberto Abrão; García-Samaniego, Javier; Gerstoft, Jan; Gíria, José; Gonçales, Fernando Lopes; Pessôa, Mário; Hézode, Christophe; Hindman, S. J.; Hofer, Harald; Husa, Petr; İdilman, Ramazan; Kåberg, Martin; Kaita, Kelly; Kautz, Achim; Kaymakoğlu, Sabahattin; Krajden, Mel; Krarup, Henrik; Laleman, Wim; Lavanchy, Daniel; Lázaro, Pablo; Marinho, Rui Tato; Marotta, Paul; Mauss, Stefan; Corrêa, Maria Cássia Mendes; Moreno, Christophe; Müllhaupt, Beat; Myers, Robert P.; Němeček, Vratislav; Øvrehus, Anne; Parkes, Julie; Peltekian, Kevork M.; Ramji, Alnoor; Razavi, Homie; Reis, N.R.S.; Roberts, Stuart K.; Roudot‐Thoraval, Françoise; Ryder, Stephen; Sarmento‐Castro, Rui; Sarrazin, Christoph; Semela, David; Sherman, Morris; Shiha, Gamal; Šperl, Jan; Stärkel, Peter; Stauber, Rudolf; Thompson, Alexander; Urbánek, Petr; Damme, Pierre Van; Thiel, Ingo van; Vandijck, Dominique; Vogel, Wolfgang; Waked, Imam; Weis, Nina; Wiegand, Johannes; Yosry, Ayman; Zekry, Amany; Negro, Francesco; Sievert, William; Gower, E.

doi:10.1111/jvh.12249

Cited by 184 publications

(163 citation statements)

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“…For the modeling of the future disease burden, a recently presented disease progression model was used [13]. The treatment strategies presented in the previously published analysis [12] differ from the strategies presented here. As described below, these strategies are clinical in approach and consider the probable impact that budget restrictions may have on treatment uptake.…”

Section: Methodsmentioning

confidence: 99%

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The future disease burden of hepatitis C virus infection in Sweden and the impact of different treatment strategies

Duberg

Blach

Falconer

et al. 2014

Scandinavian Journal of Gastroenterology

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Objective. Recently, new highly effective direct-acting antivirals (DAAs) against hepatitis C virus (HCV) were introduced. Whether these will alleviate the anticipated increase of liver disease burden in Sweden is unknown, partly because high costs may restrict the use. The objectives were to model the HCV epidemic in Sweden, the burden of disease, and the potential impact of different treatment strategies. Material and methods. HCV disease progression was modeled to 2030. Scenarios were simulated using new DAAs with sustained annual treatment rate (n = 1130), reduced treatment rate (n = 380) to maintain budget, and increased treatment rates (n = 1430 or 2260) to reduce HCV infections. Results. With today's triple therapies, the estimated number of serious liver complications and death are expected to peak in 2021. Using new DAAs among F0-F4 patients, an unchanged annual treatment rate can reduce the number of HCV infections by 10% by 2030; however, hepatocellular carcinoma (HCC) and mortality will remain unchanged. By reducing to 380 treatments annually and focusing on patients with advanced fibrosis (F3-F4), serious complications will remain constant but the total number of HCV infections will increase. By doubling the number of DAA treatments, HCC-incidence and liver-related deaths would decrease by 65-70% by 2030. Conclusion. Mortality and HCC can be reduced with new DAAs and sustained treatment uptake when restricted to F2-F4 patients, or with increased uptake in F0-F4 patients. Treatment restrictions to limit cost may reduce the positive effects and increase the burden of HCV infection. These results may be important for the future strategies of HCV management.

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Section: Methodsmentioning

confidence: 99%

“…Recently, studies of the historical HCV epidemiology, the future disease burden using today's treatment, and strategies for viral eradication were published for 16 countries including Sweden [12][13][14]. Taking into consideration the initial high costs of new DAAs, the viral eradication strategy is likely out of reach in the near future.…”

Section: Introductionmentioning

confidence: 99%

The future disease burden of hepatitis C virus infection in Sweden and the impact of different treatment strategies

Duberg

Blach

Falconer

et al. 2014

Scandinavian Journal of Gastroenterology

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“…Despite the decreasing number of hepatitis C and B virus infections, the number of patients with NAFLD and particularly advanced liver disease (NASH) will be increasing (69)(70)(71)(72)(73)(74). We need to decrease the prevalence of the obesity burden and reduce the disease burden (NAFLD and NASH) and related morbidity and mortality in the world.…”

Section: Therapy Of Nafld and Nashmentioning

confidence: 99%

Nonalcoholic fatty liver disease: Diagnosis, pathogenesis, and management

Başaranoğlu

Örmeci²

2014

Turk J Gastroenterol

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Nonalcoholic fatty liver disease (NAFLD) is an umbrella term that covers both a relatively benign condition, which is simple steatosis, and nonalcoholic steatohepatitis (NASH). NASH is characterized by a chronic and progressive liver pathology that may progress to cirrhosis, end-stage liver disease, hepatocellular carcinoma, and liver transplantation. Despite the growing body of evidence, one of the important and unresolved problems is the pathogenesis of NASH. It might be a metabolic disturbance as a primary abnormality in NAFLD. Insulin resistance is at the center of these metabolic abnormalities. Then, hepatocyte injury might be induced by oxidative stress. This ongoing process progresses to NASH, even to cirrhosis in some patients. In addition to oxidative stress, possibilities for the next hit are lipid peroxidation, reactive metabolites, adipose tissue products, transforming growth factor-b 1 , Fas ligand, mitochondrial dysfunction, respiratory chain deficiency, and intestinal microbiota. Currently, there is no well-established and approved therapy. Recommendations are to improve existing co-morbidities, such as obesity, hyperlipidemia, or type 2 diabetes, and lifestyle modification with weight loss and exercise.

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“…This is important as some developing countries have achieved much on the prevention front of Hepatitis B crease the diagnosis and treatment 5 fold. 9 So we planned a community-based cross-sectional study at Ibn-e-Siena Hospital and Research Centre to examine the prevalence of HBsAg and Anti-HCV in Southern Punjab population.…”

Section: Introductionmentioning

confidence: 99%