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The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study
Author(s) -
Wu Jie,
Zhou Yuqing,
Fu Xiaofang,
Deng Min,
Zheng Yang,
Tian Guo,
Li Yiping,
Wang Chencheng,
Ding Cheng,
Ruan Bing,
Yang Shigui,
Li Lanjuan
Publication year - 2019
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.30476
Subject(s) - medicine , china , hepatitis c virus , hepatitis c , disease burden , scenario analysis , confidence interval , disease , intensive care medicine , environmental health , virology , virus , geography , business , archaeology , finance
The launch of new direct‐acting antivirals (DAAs) is expected to substantially reduce the burden of hepatitis C virus (HCV) in China. However, the effect of these changes has not yet been modeled in China. Therefore, we aim to predict the burden of HCV‐related diseases in China by simulating different scenarios that incorporate recent therapeutic advances of HCV and China’s current screening strategy. We developed an individual‐based microsimulation Markov model that simulated disease progression of HCV‐infected patients in China from 2004 to 2050. We simulated four scenarios with different assumptions about treatment, including a natural history scenario, a pre‐DAAs scenario, a DAA treatment for all patients with a METAVIR fibrosis score ≥F3 (DAAs [≥F3]) scenario, and a DAAs (≥F0) scenario. The introduction of DAAs is predicted to have great impacts on the burden of HCV in China, particularly under the DAAs (≥F0) scenario in which we rapidly expand DAAs to all HCV‐infected patients (≥F0) in 2021. Under this scenario, prevalence of chronic HCV is expected to peak at 10.75 million (95% confidence interval [CI], 8.30‐12.85) around 2020 and then decrease to 7.92 million (95% CI, 5.41‐10.08) in 2050. Conclusion: If the future increasing burden of HCV‐related diseases is to be averted, China needs to start launching the new DAA treatment and rapidly increase the number of patients treated. However, to maximize the benefits of new DAAs, expanded screening is necessary to identify more cases that require treatment in the short term. Without these changes, the HCV burden in China will remain high in the future.