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Forecasting Hepatitis C liver disease burden on real‐life data. Does the hidden iceberg matter to reach the elimination goals?
Author(s) -
Kondili Loreta A.,
Robbins Sarah,
Blach Sarah,
Gamkrelidze Ivane,
Zignego Anna L.,
Brunetto Maurizia R.,
Raimondo Giovanni,
Taliani Gloria,
Ian Andrea,
Russo Francesco P.,
Santantonio Teresa A.,
Zuin Massimo,
Chessa Luchino,
Blanc Pierluigi,
Puoti Massimo,
Vinci Maria,
Erne Elke M.,
Strazzabosco Mario,
Massari Marco,
Lampertico Pietro,
Rumi Maria G.,
Federico Alessandro,
Orlandini Alessandra,
Ciancio Alessia,
Borgia Guglielmo,
Andreone Pietro,
Caporaso Nicola,
Persico Marcello,
Ieluzzi Donatella,
Madonia Salvatore,
Gori Andrea,
Gasbarrini Antonio,
Coppola Carmine,
Brancaccio Giuseppina,
Andriulli Angelo,
Quaranta Maria G.,
Montilla Simona,
Razavi Homie,
Melazzini Mario,
Vella Stefano,
Craxì Antonio
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13901
Subject(s) - medicine , hepatitis c , disease burden , disease , liver disease , health care , intensive care medicine , pediatrics , environmental health , economic growth , economics
Background & Aims Advances in direct‐acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked‐to‐care individuals on overall HCV burden estimates and identified a possible strategy to achieve the WHO targets by 2030. Methods Using a modelling approach grounded in Italian real‐life data of diagnosed and treated patients, different linkage‐to‐care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals. Results Under the 40% linked‐to‐care scenario, viraemic burden would decline (60%); however, eligible patients to treat will be depleted by 2025. Increased case finding through a targeted screening strategy in 1948‐1978 birth cohorts could supplement the pool of diagnosed patients by finding 75% of F0‐F3 cases. Under the 60% linked‐to‐care scenario, viraemic infections would decline by 70% by 2030 but the patients eligible for treatment will run out by 2028. If treatment is to be maintained, a screening strategy focusing on 1958‐1978 birth cohorts could capture 55% of F0‐F3 individuals. Under the 80% linked‐to‐care scenario, screening limited in 1968‐1978 birth cohorts could sustain treatment at levels required to achieve the HCV elimination goals. Conclusion In Italy, which is an HCV endemic country, the eligible pool of patients to treat will run out between 2025 and 2028. To maintain the treatment rate and achieve the HCV elimination goals, increased case finding in targeted, high prevalence groups is required.