Hepatitis C disease burden and strategies for elimination by 2030 in Brazil. A mathematical modeling approach

Benzaken, Adèle Schwartz; Girade, Renato; Catapan, Elisa; Pereira, Gérson Fernando Mendes; Almeida, Elton Carlos de; Vivaldini, Simone Monzani; Fernandes, Neide; Razavi, Homie; Schmelzer, Jonathan; Ferraz, Maria Lúcia Cardoso Gomes; Ferreira, Paulo Roberto Abrão; Pessôa, Mário; Martinelli, Ana de Lôurdes Candolo; Souto, Francisco José Dutra; Walsh, Nick; Mendes‐Correa, Maria Cássia

doi:10.1016/j.bjid.2019.04.010

Cited by 47 publications

(57 citation statements)

References 18 publications

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“…In 2016, the Brazilian Ministry of Health estimated a prevalence of 0.70% nationwide and of 657,000 people with the active hepatitis C virus, aiming to establish a baseline to estimate the cases to be diagnosed and treated annually, in order to meet targets and eliminate viral hepatitis by 2030 5 . In a more recent publication, these estimates were updated to 0.53% and 632,000, respectively 6 . This information shows the importance of these infections in Brazil and the challenge for health services in detecting and treating patients.…”

Section: Introductionmentioning

confidence: 99%

“…Em 2016, o Ministério da Saúde estimou prevalência de 0,70% no país todo e de 657.000 pessoas com o vírus ativo da hepatite C, visando estabelecer uma linha de base para calcular os casos a diagnosticar e tratar anualmente, a fim de cumprir metas e eliminar as hepatites virais até 2030 5 . Em publicação mais recente essas estimativas foram atualizadas para 0,53% e 632.000, respectivamente 6 . Essas informações mostram a importância dessas infecções no Brasil e o desafio para os serviços de saúde em detectar e tratar os portadores.…”

Section: Introductionunclassified

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Tendência de mortalidade por hepatites B e C no município de São Paulo, 2002–2016

et al. 2020

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OBJETIVO: Descrever a mortalidade por hepatites B e C como causa básica no município de São Paulo, verificando a tendência dessas taxas, e avaliar a associação dessas doenças a outras no período de 2002 a 2016. MÉTODOS: Trata-se de um estudo de série temporal sobre mortalidade por hepatites B e C segundo sexo, com dados do Sistema de Informação de Mortalidade. A regressão de Prais Winsten foi usada na análise de tendência das taxas. RESULTADOS: Os achados do presente estudo mostraram tendência de declínio da mortalidade por hepatites B e C nos últimos anos, particularmente entre pessoas do sexo masculino. Essas infecções foram causas associadas importantes ao carcinoma de células hepáticas e ao HIV. Destaca-se a proporção de óbitos com menos de 70 anos de idade. CONCLUSÕES: O estudo fornece uma linha de base para pesquisas de tendência de mortalidade e de impacto de intervenções, visto o histórico de ampliação da detecção e oferta de tratamentos, incluindo os mais recentes antivirais no Brasil, desde 2015.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

Tendência de mortalidade por hepatites B e C no município de São Paulo, 2002–2016

et al. 2020

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“…Brazil's National Report for HCV treatment was launched in 2015, elaborated by the Brazilian Ministry of Health (MoH-Brazil), and adopted by SUS [6] . In 2018, the MoH-Brazil took a step forward to support the development and implementation of national multi-sector policies and strategies for hepatitis prevention and control in Brazil, for all HCV-infected patients, regardless of the degree of liver fibrosis [12] .…”

Section: Introductionmentioning

confidence: 99%

“…SUS supported the annual cost per capita of US$ 6,152.85 on average for DAA-based therapies from 2015 to 2018 [14] . The Ministry of Health has developed a mathematical model to better understand the national prevalence data and establish its own elimination goals, including an estimation of the number of people to be treated [5,15].…”

Section: Introductionmentioning

confidence: 99%

A Real-life Study of the Positive Response to DAA-based Therapies for Hepatitis C in Brazil

Vivaldini

Ribeiro

Júnior

et al. 2020

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Treating hepatitis C virus (HCV) infections reduces overall mortality and the risk of multiple extrahepatic complications. Direct-acting antivirals (DAAs) are molecules that target specific non-structural proteins of the virus, resulting in the disruption of viral replication and infection. This report describes the activities undertaken to assess the cure of HCV in patients of different age groups, supported by the Viral Hepatitis National Program of the Unified Health System in Brazil. Around 11,000 patients wereevaluated in an electronic retrospective cohort, which used therapeutic schemes with Sofosbuvir (SOF), Daclatasvir (DCV), Simeprevir (SMV), and an association of Ombitasvir, Veruprevir/Ritonavir and Dasabuvir (3D) with or without Ribavirin (RBV), with sustained virologic response (SVR) or viral cure after a 12-week treatment. We conducted logistic regressions to identify factors independently associated with positive response to DAA-based therapies. Among evaluated patients, 57.1% were male; 48.3% identified as white; 78.3% were over 50 years old; 44.1% were from the Southeast region; 47.7% had genotype 1b; and 84.5% were treated for 12 weeks. The SVR rates with DAAs ranged from 87% to 100%. Genotypes 1 and 4 had a better response (96.3 to 100% of SVR) to therapy with DAAs, and genotypes 2 and 3 had SVR of 90.6% to 92.2%. Different treatment periods showed SVR with an average of 95.0% and 95.9% for 12 and 24 weeks, respectively. In the odds ratio assessment, we verified that females were half as likely (OR 0.5; CI 95% 0.4-0.6) to have a negative response to therapy, when compared to males, and that genotypes 2 and 3 were around twice more likely (OR 1.5-2.2; CI 95% 0.7-2.9; 1.2-3.6 and OR 2.7-2.8; CI 95% 2.0-3.8, respectively) to not have SVR after therapy when compared to genotype 1. Patients aged between 50 and 69 years old were 1.2 times (OR 1,2; CI95% 0,7-1,9) more likely to not have SVR when treated with DAAs, when compared to other age groups. This study is the first of this magnitude to be held in a Latin-American country with high SVR results, supported by a free-of- charge universal and public health system. We confirm the high performance of DAA-based therapies which support the Brazilian public health policy decision of adopting them as an important part of the countrys strategy to eliminate HCV by 2030.

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“…Em relação aos números brasileiros, um estudo recente demonstrou que em 2017 a prevalência de anti-HCV reagente era de 0,53% e que a estimativa de indivíduos com HCV-RNA detectável era de 632.000 (0,31% da população total) 61 .…”

Section: Diagnóstico E Tratamentounclassified

Avaliação do risco e causas de óbito entre indivíduos diagnosticados com hepatite C através de exames de triagem para doação de sangue, no período de 1994 a 2016, em um hemocentro de São Paulo-SP

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Hepatitis C disease burden and strategies for elimination by 2030 in Brazil. A mathematical modeling approach

Cited by 47 publications

References 18 publications

Tendência de mortalidade por hepatites B e C no município de São Paulo, 2002–2016

Tendência de mortalidade por hepatites B e C no município de São Paulo, 2002–2016

A Real-life Study of the Positive Response to DAA-based Therapies for Hepatitis C in Brazil

Avaliação do risco e causas de óbito entre indivíduos diagnosticados com hepatite C através de exames de triagem para doação de sangue, no período de 1994 a 2016, em um hemocentro de São Paulo-SP

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