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Epidemiol Infect. 2016 Dec;144(16):3376-3386. doi: 10.1017/S0950268816001722. Epub 2016 Aug 5.

Chronic hepatitis C virus (HCV) burden in Rhode Island: modelling treatment scale-up and elimination.

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Department of Epidemiology,Brown University School of Public Health,Providence,RI,USA.
Center for Disease Analysis,Lafayette,CO,USA.
Department of Health Services Policy and Practice,Brown University School of Public Health,Providence,RI,USA.
Division of Infectious Diseases,The Warren Alpert Medical School of Brown University, andThe Miriam Hospital,Center for AIDS Research (CFAR) Providence,RI,USA.


We utilized a disease progression model to predict the number of viraemic infections, cirrhotic cases, and liver-related deaths in the state of Rhode Island (RI) under four treatment scenarios: (1) current HCV treatment paradigm (about 215 patients treated annually, Medicaid reimbursement criteria fibrosis stage ⩾F3); (2) immediate scale-up of treatment (to 430 annually) and less restrictive Medicaid reimbursement criteria (fibrosis stage ⩾F2); (3) immediate treatment scale-up and no fibrosis stage-specific Medicaid reimbursement criteria (⩾F0); (4) an 'elimination' scenario (i.e. a continued treatment scale-up needed to achieve >90% reduction in viraemic cases by 2030). Under current treatment models, the number of cirrhotic cases and liver-related deaths will plateau and peak by 2030, respectively. Treatment scale-up with ⩾F2 and ⩾F0 fibrosis stage treatment criteria could reduce the number of cirrhotic cases by 21·7% and 10·0%, and the number of liver-related deaths by 19·3% and 7·4%, respectively by 2030. To achieve a >90% reduction in viraemic cases by 2030, over 2000 persons will need to be treated annually by 2020. This strategy could reduce cirrhosis cases and liver-related deaths by 78·9% and 72·4%, respectively by 2030. Increased HCV treatment uptake is needed to substantially reduce the burden of HCV by 2030 in Rhode Island.


Disease burden; HCV; epidemiology; hepatitis C; modelling; treatment

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