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

Gountas, Ilias; Sypsa, Vana; Papatheodoridis, George V.; Souliotis, George; Razavi, Homie; Hatzakis, Angelos

doi:10.1111/jgh.13485

Cited by 10 publications

(15 citation statements)

References 21 publications

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“…Our model predicted that there were 9.7 million chronic HCV cases in 2015 in China (pre-DAAs scenario), which is within the 95% CI of the 9.8 million (95% CI, 6.7-10.8) cases estimated in another modeling study. (4) Thein et al's meta-analysis estimated a cumulative probability of cirrhosis (F4) of 16% (95% CI, [14][15][16][17][18][19] at year 20 and 41% (95% CI, 36-45) at year 30. (18) Our model predicted the cumulative probabilities of cirrhosis (F4) to be 14.7% and 44.3% at years 20 and 30, respectively (Supporting Fig.…”

Section: Validationmentioning

confidence: 99%

“…The launch of DAAs is expected to substantially reduce the burden of HCV in China. Several modeling studies have simulated this impact of DAAs in the United States, Australia, and European countries . However, the effect of these changes has not yet been modeled in China.…”

mentioning

confidence: 99%

“…Several modeling studies have simulated this impact of DAAs in the United States, (9)(10)(11)(12) Australia, (13) and European countries. (14)(15)(16) However, the effect of these changes has not yet been modeled in China. In addition, previous modeled scenarios were set to represent country-specific situations, such as birth-cohort screening strategies, different treatment guidelines, and different timelines of DAA availability.…”

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confidence: 99%

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The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

Zhou

et al. 2019

Hepatology

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The launch of new direct‐acting antivirals (DAAs) is expected to substantially reduce the burden of hepatitis C virus (HCV) in China. However, the effect of these changes has not yet been modeled in China. Therefore, we aim to predict the burden of HCV‐related diseases in China by simulating different scenarios that incorporate recent therapeutic advances of HCV and China’s current screening strategy. We developed an individual‐based microsimulation Markov model that simulated disease progression of HCV‐infected patients in China from 2004 to 2050. We simulated four scenarios with different assumptions about treatment, including a natural history scenario, a pre‐DAAs scenario, a DAA treatment for all patients with a METAVIR fibrosis score ≥F3 (DAAs [≥F3]) scenario, and a DAAs (≥F0) scenario. The introduction of DAAs is predicted to have great impacts on the burden of HCV in China, particularly under the DAAs (≥F0) scenario in which we rapidly expand DAAs to all HCV‐infected patients (≥F0) in 2021. Under this scenario, prevalence of chronic HCV is expected to peak at 10.75 million (95% confidence interval [CI], 8.30‐12.85) around 2020 and then decrease to 7.92 million (95% CI, 5.41‐10.08) in 2050. Conclusion: If the future increasing burden of HCV‐related diseases is to be averted, China needs to start launching the new DAA treatment and rapidly increase the number of patients treated. However, to maximize the benefits of new DAAs, expanded screening is necessary to identify more cases that require treatment in the short term. Without these changes, the HCV burden in China will remain high in the future.

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Section: Validationmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

Zhou

et al. 2019

Hepatology

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“…The most striking success in scale-up of this communitybased model was in overcoming the key challenges encountered with other large-scale national and community HCV test and treat programmes-namely, the low uptake of HCV RNA testing following positive serological tests and following treatment, as well as overall poor access and coverage among the general population in rural areas. [20][21][22] There were several distinctive features of our approach that contributed to its successful implementation across a wide range of villages. First and foremost, the strong community engagement, empowerment and commitment to implementing the project activities through community-based associations, local village leadership and village promoters.…”

Section: Discussionmentioning

confidence: 99%

An educate, test and treat model towards elimination of hepatitis C infection in Egypt: Feasibility and effectiveness in 73 villages

Shiha

Soliman

Mikhail

et al. 2020

Journal of Hepatology

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The treatment coverage and cure of 84.6% of the estimated 17,137 infected persons aged 12-80 years across 73 villages. >200,000 rural villagers Large community-based educate, test and treat programme Programme to eliminate HCV infection in Egypt rural communities Highlights An Educate, test and treat model programme is feasible and effective for HCV elimination in rural communities. Over 200,000 villagers were screened for HCV and there were high levels of linkage across all steps in the care cascade. A total of 14,495 infected patients received treatment.

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“…[43]); however as of 2016 there remains a sizable patient population who would clearly benefit from DAA therapy but are untreated or receiving clearly inferior regimens. For instance, in Greece–which has one of the highest rates of HCV prevalence in Europe with 14% of patients having GT4 –PR-only regimens remain widely used with estimated SVR of just 65% following 48 weeks of treatment [44]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy of a 12-Week Simeprevir Plus Peginterferon/Ribavirin (PR) Regimen in Treatment-Naïve Patients with Hepatitis C Virus (HCV) Genotype 4 (GT4) Infection and Mild-To-Moderate Fibrosis Displaying Early On-Treatment Virologic Response

et al. 2017

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BackgroundHCV GT4 accounts for up to 20% of HCV infections worldwide. Simeprevir, given for 12 weeks as part of a 24- or 48-week combination regimen with PR is approved for the treatment of chronic HCV GT4 infection. Primary study objectives were assessment of efficacy and safety of simeprevir plus PR in treatment-naïve patients with HCV GT4 treated for 12 weeks. Primary efficacy outcome was sustained virologic response 12 weeks post-treatment (SVR12). Additional objectives included investigation of potential associations of rapid virologic response and baseline factors with SVR12.MethodsThis multicentre, open-label, single-arm study (NCT01846832) evaluated efficacy and safety of simeprevir plus PR in 67 patients with HCV GT4 infection. Patients were treatment-naïve, aged 18–70 years with METAVIR F0–F2 fibrosis. Patients with early virologic response (HCV RNA <25 IU/mL [detectable/undetectable in IL28B CC patients or undetectable in IL28B CT/TT patients] at Week 2 and undetectable at Weeks 4 and 8) were eligible to stop all treatment at the end of Week 12, otherwise PR therapy was continued to Week 24.ResultsOf 67 patients treated, 34 (51%) qualified for 12-week treatment including all but one patient with IL28B CC genotype (14/15). All patients in the 12-week group had undetectable HCV RNA at end of treatment, and 97% (33/34) achieved SVR12. No new safety signals with simeprevir plus PR were identified. The proportion of patients experiencing Grade 3–4 adverse events was lower in the 12-week group than in the 24-week group.ConclusionsOur findings on simeprevir plus PR therapy shortened to 12 weeks in patients with HCV GT4 infection with favourable baseline characteristics and displaying early on-treatment virologic response are encouraging. No new safety signals were associated with simeprevir plus PR in this study.Trial RegistrationNCT01846832

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

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

Cited by 10 publications

References 21 publications

The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

An educate, test and treat model towards elimination of hepatitis C infection in Egypt: Feasibility and effectiveness in 73 villages

Efficacy of a 12-Week Simeprevir Plus Peginterferon/Ribavirin (PR) Regimen in Treatment-Naïve Patients with Hepatitis C Virus (HCV) Genotype 4 (GT4) Infection and Mild-To-Moderate Fibrosis Displaying Early On-Treatment Virologic Response

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