Estimation of Hepatitis C Disease Burden and Budget Impact of Treatment Using Health Economic Modeling

Chhatwal, Jagpreet; Chen, Qiushi; Aggarwal, Rakesh

doi:10.1016/j.idc.2018.02.008

Cited by 17 publications

(20 citation statements)

References 45 publications

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“…First, the number of HCV‐positive NHANES participants during 2013‐2016 is small (n = 185 antibody‐positive, n = 117 RNA‐positive), even in this large nationally representative sample (n = 12,105 participants aged 18 years and older, of whom n = 10,857 were tested for HCV); although NHANES uses extensively tested protocols to encourage participation even in sensitive aspects of the study, if participants who did not participate in the examination component (n = 446), did not undergo HCV testing or provide a blood sample sufficient to yield conclusive HCV test results (n = 789), or opted not to participate in NHANES at all (n = 6,715, or 37% of, selected participants aged 20 years and above during 2013‐2016) were disproportionately persons who had previously or concurrently injected drugs, NHANES may underestimate HCV prevalence even in the noninstitutionalized civilian population. However, one study, based on a dynamic model of HCV infection among the NHANES‐eligible population from 2001 and beyond, estimated that 1.84 million noninstitutionalized people were HCV RNA–positive in the United States in 2015 . This estimate is only 15% lower than our estimate of HCV RNA prevalence in the noninstitutionalized civilian population during 2013‐2016.…”

Section: Discussioncontrasting

confidence: 73%

“…However, one study, based on a dynamic model of HCV infection among the NHANESeligible population from 2001 and beyond, estimated that 1.84 million noninstitutionalized people were HCV RNA-positive in the United States in 2015. (49) This estimate is only 15% lower than our estimate of HCV RNA prevalence in the noninstitutionalized civilian population during 2013-2016. Second, the effect of the NHANES change in laboratory testing methods on HCV antibody and RNA prevalence estimates before and after 2013 could not be assessed within the NHANES population, and thus any comparison of our current findings with previous estimates should be interpreted with caution.…”

Section: Discussioncontrasting

confidence: 54%

See 1 more Smart Citation

Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013‐2016

Hofmeister

Rosenthal

Barker³

et al. 2018

Hepatology

406

372

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Hepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in the United States, causing substantial morbidity and mortality and costing billions of dollars annually. To update the estimated HCV prevalence among all adults aged ≥18 years in the United States, we analyzed 2013‐2016 data from the National Health and Nutrition Examination Survey (NHANES) to estimate the prevalence of HCV in the noninstitutionalized civilian population and used a combination of literature reviews and population size estimation approaches to estimate the HCV prevalence and population sizes for four additional populations: incarcerated people, unsheltered homeless people, active‐duty military personnel, and nursing home residents. We estimated that during 2013‐2016 1.7% (95% confidence interval [CI], 1.4‐2.0%) of all adults in the United States, approximately 4.1 (3.4‐4.9) million persons, were HCV antibody‐positive (indicating past or current infection) and that 1.0% (95% CI, 0.8‐1.1%) of all adults, approximately 2.4 (2.0‐2.8) million persons, were HCV RNA–positive (indicating current infection). This includes 3.7 million noninstitutionalized civilian adults in the United States with HCV antibodies and 2.1 million with HCV RNA and an estimated 0.38 million HCV antibody‐positive persons and 0.25 million HCV RNA–positive persons not part of the 2013‐2016 NHANES sampling frame. Conclusion: Over 2 million people in the United States had current HCV infection during 2013‐2016; compared to past estimates based on similar methodology, HCV antibody prevalence may have increased, while RNA prevalence may have decreased, likely reflecting the combination of the opioid crisis, curative treatment for HCV infection, and mortality among the HCV‐infected population; efforts on multiple fronts are needed to combat the evolving HCV epidemic, including increasing capacity for and access to HCV testing, linkage to care, and cure.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussioncontrasting

confidence: 54%

Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013‐2016

Hofmeister

Rosenthal

Barker³

et al. 2018

Hepatology

406

372

View full text Add to dashboard Cite

show abstract

“…(42) Mathematical models suggest that hepatitis C treatment can also reduce population prevalence among groups at highest HCV infection risk and prevent new transmissions. (2,39) In addition to development of effective interventions for delivery of these services, comprehensive care is needed for persons who inject drugs to sustain hepatitis C prevention programs. (24,39,43) One important limitation of our analysis is the inability to produce separate state-level hepatitis C prevalence estimates for Hispanics.…”

Section: Discussionmentioning

confidence: 99%

“…H epatitis C virus (HCV) infection is a leading cause of liver-related morbidity and mortality, and its sequelae cost billions of dollars in health care spending each year. (1)(2)(3) Despite being underdiagnosed and underreported, hepatitis C is the most commonly reported bloodborne infection in the United States. (1,4,5) More than 2 million adults in the United States are estimated to be currently infected.…”

mentioning

confidence: 99%

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

et al. 2020

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Hepatitis C virus (HCV) infection is a leading cause of liver‐related morbidity and mortality, and more than 2 million adults in the United States are estimated to be currently infected. Reducing HCV burden will require an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. We modeled state‐level estimates of hepatitis C prevalence among U.S. adults by sex, birth cohort, and race during 2013‐2016. National Health and Nutrition Examination Survey data were used in combination with state‐level HCV‐related and narcotic overdose–related mortality data from the National Vital Statistics System and estimates from external literature review on populations not sampled in the National Health and Nutrition Examination Survey. Nationally, estimated hepatitis C prevalence was 1.3% among males and 0.6% among females (prevalence ratio [PR] = 2.3). Among persons born during 1945 to 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969 (PR = 3.2). Among persons born during 1945 to 1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia. Among persons born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Hepatitis C prevalence was 1.8% among non‐Hispanic black persons and 0.8% among persons of other races (PR = 2.2), and the magnitude of this disparity varied widely across jurisdictions (PR range: 1.3‐7.8). Overall, 23% of prevalent HCV infections occurred among non‐Hispanic black persons, whereas 12% of the population was represented by this racial group. These estimates provide information on prevalent HCV infections that jurisdictions can use for understanding and monitoring local disease patterns and racial disparities in burden of disease.

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“…Recently, combinations of DAAs have become an effective way to cover hepatitis C infection of different genotypes [6,7]. Nonetheless, according to the World Health Organization, there are several remaining challenges that must be met to eradicate HCV [1]; 1) Access to the treatment in economically-challenged areas must be increased [8]; 2) Emerging drug resistance is an expected problem even with combination therapy [9,10]; 3) Efficacy in broader sectors of HCV patients, such as elder, impaired kidney and liver patients [11].…”

mentioning

confidence: 99%

1H-Imidazole-2,5-Dicarboxamides as NS4A Peptidomimetics: Identification of a New Venue to Inhibit HCV-NS3 Protease

Omar¹,

Elfaky²,

Arold³

et al. 2020

Preprint

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The non-structural protein NS3/4A protease is a critical factor for hepatitis C virus (HCV) maturation that requires activation by NS4A. Synthetic peptide mutants of NS4A were found to inhibit NS3 function. The bridging from peptide inhibitors to heterocyclic peptidomimetics of NS4A has not been in consideration in literature, and therefore, we decided to explore this strategy to develop a new class of NS3 inhibitors. In this report, a structure-based design approach was used to convert the bound form of NS4A into 1H-imidazole-2,5-dicarboxamide derivatives as first generation peptidomimetics. This scaffold mimics the buried amino acid sequence Ile-25` to Arg-28` at the core of NS4A21`-33` needed to activate the NS3 protease. Some of the synthesized MOC compounds were able to compete with and displace NS4A21`-33` for binding to NS3. For instance, N5-(4-guanidinobutyl)-N2-(n-hexyl)-1H-imidazole-2,5-dicarboxamide (MOC-24) inhibited the binding of NS4A21`-33` with a competition IC50 of 1.9 ± 0.12 µM in a fluorescence anisotropy assay, stabilized the denaturation of NS3 by increasing the aggregation temperature by ΔTagg 0.6 ± 0.140 ℃. MOC-24 also inhibited NS3 protease activity in a fluorometric assay. Molecular dynamics simulations rationalized the structure-activity relationship (SAR) differences between the active MOC-24 and the inactive MOC-26. Our data shows that MOC compounds are possibly the first examples of NS4A peptidomimetics that demonstrated promising activities against NS3 proteins.

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Estimation of Hepatitis C Disease Burden and Budget Impact of Treatment Using Health Economic Modeling

Cited by 17 publications

References 45 publications

Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013‐2016

Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013‐2016

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

1H-Imidazole-2,5-Dicarboxamides as NS4A Peptidomimetics: Identification of a New Venue to Inhibit HCV-NS3 Protease

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