Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study
- PMID: 35180382
- DOI: 10.1016/S2468-1253(21)00472-6
Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study
Abstract
Background: Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends.
Methods: This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age ≥0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories.
Findings: Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0·7% (95% UI 0·7-0·9), corresponding to 56·8 million (95% UI 55·2-67·8) infections, on Jan 1, 2020. This number represents a decrease of 6·8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63·6 million (61·8-75·8) infections (0·9% [0·8-1·0] prevalence). By the end of 2020, an estimated 12·9 million (12·5-15·4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment.
Interpretation: At the beginning of 2020, there were an estimated 56·8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination.
Funding: John C Martin Foundation, Gilead Sciences, AbbVie, ZeShan Foundation, and The Hepatitis Fund.
Copyright © 2022 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of interests SB, CE, DMR-S, ElM, IG, KR-S, and HAR are employees of the CDAF. The CDAF has received funding from the John C Martin Foundation, ZeShan Foundation, The Hepatitis Fund, Gilead Sciences, and AbbVie. NAT reports grants or contracts from Gilead Sciences, Genentech, and Roche; consulting fees from Exigo Management, Enyo Pharma, and Pharmaceutical Product Development; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the University of Maryland. FT reports institutional research funding from Allergan, Inventiva, Bristol Myers Squibb, Gilead Sciences; and consulting fees or honoraria for lectures from Allergan, Esanum, Gilead Sciences, AbbVie, Bristol Myers Squibb, Falk, Boehringer, Galapagos, Intercept, Inventiva, Novo Nordisk, Novartis, Pfizer, and Ionis. Additionally, FT reports being Co-Editor at the Journal of Hepatology. AC reports consulting fees from AbbVie, Gilead Sciences, and Merck Sharp & Dohme; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Gilead Sciences, and Merck Sharp & Dohme. GJD reports grants or contracts from AbbVie, Gilead Sciences, and Merck. AA reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Gilead Sciences, Merck Sharp & Dohme, Swedish Orphan Biovitrum, Intercept, and Mylan. InA reports an investigator-initiated study grant to their institution from Gilead Sciences; consulting fees from Gilead Sciences and GlaxoSmithKline; payment or honoraria for lectures from Gilead Sciences, GlaxoSmithKline, and Merck; support for meeting attendance or travel from Gilead Sciences and Merck; and advisory board participation for Gilead Sciences and GlaxoSmithKline. MAB reports contracts for lectures or presentations, with no impact on the contents, from Gilead Sciences; and funding from AbbVie for a research project, not for personal use and with no impact on the contents or reporting. SA reports research grants from AbbVie and Gilead Sciences; honoraria for lectures or consultancy from AbbVie, Bristol Myers Squibb, Gilead Sciences, and Merck Sharp & Dohme. MIA reports research funding from Prenetics and Pfizer. MJB reports research support and consulting fees from AbbVie, Gilead Sciences, and Specialty Rx Solutions. KAB reports research support to their institution in the form of past grants or contracts from Gilead Sciences; personal consulting fees for advisory board participation from Gilead; payment or honoraria for speakers bureaus from Gilead; and leadership or fiduciary roles in the American Association for the Study of Liver Diseases Foundation (board member) and Children's Liver Disease Foundation (board member). RSBJr reports grants and research support from AbbVie and Gilead Sciences. PB reports research grants from Gilead Sciences; speaker's fees from Gilead Sciences and AbbVie; and travel grants from Gilead Sciences and AbbVie. PB is the Chair of Swiss Hepatitis and sits on the board of the Swiss Association for the Medical Management in Substance Users and the Swiss Hepatitis C Association. MRB reports consulting fees from Gilead Sciences; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Gilead Sciences, and Eisai–Merck Sharp & Dohme; support for meeting attendance or travel from Gilead Sciences and AbbVie; and participation on a data safety monitoring board or advisory board for Roche, AbbVie, Gilead Sciences, Janssen, and Eisai–Merck Sharp & Dohme. MRB is the coordinator of the working group for the implementation of the regional government resolution (number 397; April, 2018) for HCV infection control in Tuscany, Italy. DB reports travel grants from AbbVie and Gilead Sciences and research grants from Gilead Sciences. MarB reports grants or contracts from Gilead Sciences and AbbVie; consulting fees from Gilead Sciences; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Gilead Sciences and AbbVie. JoC reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie and Gilead Sciences; and support for meeting attendance or travel from AbbVie and Gilead Sciences. 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RES reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie; support for meeting attendance or travel from AbbVie; and participation on a data safety monitoring board or advisory board for Bristol Myers Squibb, Lilly, Roche, and Gilead Sciences. CAMS reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie; participation on a data safety monitoring board or advisory board for AbbVie; leadership or fiduciary roles in other board, society, committee, or advocacy groups, paid or unpaid for the New Zealand Society of Gastroenterology. VS reports grants from Gilead Sciences and AbbVie. IT reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Merck Sharp & Dohme, Roche, Swedish Orphan Biovitrum, and Gilead Sciences; and support for meeting attendance or travel from AbbVie and Merck Sharp & Dohme. KT reports grants from AbbVie, Gilead Sciences, and Roche. DAMCV reports grants or contracts from the US National Institutes of Health, Gilead Sciences, and ViiV Healthcare. HVV reports the following issued patents: glycomics on PNF after liver transplantation (patent number WO/2017/001600 A1); and glycomics on HCC recurrence after liver transplantation (patent number WO/2021/191372 A1). TV reports grants or contracts from Gilead Sciences, Janssen Pharmaceuticals, and AbbVie; consulting fees from AbbVie and Gilead Sciences; and support for meeting attendance or travel from Gilead Sciences and AbbVie. FGV reports travel support from Gador Argentina for the International Liver Transplantation Society Congress (2018 and 2019) and American Association for the Study of Liver Diseases Liver Meeting (2018 and 2019); leadership or fiduciary roles in the non-profit foundation President Fundacion para la Docencia e Investigacion de las Enfermedades del Higado. AV reports speaker fees for Gilead Sciences, AbbVie, and Merck Sharp & Dohme. NW reports unrestricted grants for research from AbbVie and Gilead Sciences; and being a clinical investigator, lecturer, or member of advisory boards for AbbVie, Gilead Sciences, GlaxoSmithKline, and Merck Sharp & Dohme. VW-SW reports research grants from Gilead Sciences; consultancy for AbbVie, Allergan, Boehringer Ingelheim, Echosens, Gilead Sciences, Inventiva, Merck, Novartis, Novo Nordisk, Pfizer, ProSciento, Sagimet Biosciences, Target PharmaSolutions, and Terns Pharmaceuticals; honoraria for lectures for Abbott, AbbVie, Echosens, Gilead Sciences, and Novo Nordisk; co-founder of Illuminatio Medical Technology. SZ reports advisory boards or speaker's bureau for AbbVie, BioMarin, Gilead Sciences, Intercept, Janssen, Merck or Merck Sharp & Dohme, Novo Nordisk, and Swedish Orphan Biovitrum. HAR reports payments to their institution for serving as a member of advisory boards for Janssen, Roche, Gilead Sciences, AbbVie, Abbott, Merck, and VBI Vaccines; and serving as an unpaid member of the board for CDA Foundation. All other authors declare no competing interests.
Comment in
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Global elimination of hepatitis C: a warning from the data.Lancet Gastroenterol Hepatol. 2022 May;7(5):380-381. doi: 10.1016/S2468-1253(22)00009-7. Epub 2022 Feb 16. Lancet Gastroenterol Hepatol. 2022. PMID: 35180383 No abstract available.
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