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J Gastroenterol Hepatol. 2017 Feb;32(2):466-472. doi: 10.1111/jgh.13485.

Is elimination of HCV possible in a country with low diagnostic rate and moderate HCV prevalence?: The case of Greece.

Author information

1
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
2
Department of Gastroenterology, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
3
Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece.
4
Center for Disease Analysis, Lafayette, Colorado, USA.

Abstract

BACKGROUND AND AIM:

The treatment of hepatitis C (HCV) with interferon (IFN)-free direct-acting antivirals (DAAs) is anticipated to change the future burden of disease. The aim of this study is to quantify the impact of IFN-free DAAs on HCV-related morbidity and mortality in Greece under different scenarios concerning treatment coverage and primary prevention, including the proposed by World Health Organization Global Hepatitis Strategy.

METHODS:

A previously described model was used to project the future disease burden up to 2030 under scenarios, which includes treatment based on the combination of pegylated-IFN with ribavirin (base case) and scenarios using DAAs therapies.

RESULTS:

Under the base case scenario, an increase in HCV-related morbidity and mortality is predicted in Greece (mortality in 2030: +23.6% compared with 2015). If DAAs are used with the same treatment coverage, the number of hepatocellular carcinoma cases and of liver related deaths are predicted to be lower by 4-7% compared with 2015. Under increased treatment coverage (from 2000 treated/year to approximately 5000/year in 2015-2020 and 2500/year subsequently), morbidity and mortality will decrease by 43-53% in 2030 compared with 2015. To achieve the WHO Global Hepatitis Strategy goals, a total number of 86 500 chronic hepatitis C patients will have to be treated during 2015-2030.

CONCLUSIONS:

Elimination of HCV in Greece by 2030 necessitates great improvements in primary prevention, implementation of large screening programs and high treatment coverage.

KEYWORDS:

Greece; disease burden; elimination; hepatitis C; modeling; projections

PMID:
27403912
DOI:
10.1111/jgh.13485
[Indexed for MEDLINE]

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