Number of people treated for hepatitis C virus infection in 2014-2023 and applicable lessons for new HBV and HDV therapies
Homie RazaviCenter for Disease Analysis Foundation, Lafayette, United States. Electronic address: [email protected]Imam WakedHepatology, National Liver Institute, Shebeen El Kom, EgyptHuma QureshiGastroenterologist, Focal Point Hepatitis, Ministry of National Health Services, Regulations and Coordination, Islamabad, PakistanLoreta A. KondiliNational Center for Global Health, Istituto Superiore di Sanita, Rome, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, ItalyAnn‐Sofi DubergDepartment of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, SwedenSoo AlemanDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, SwedenJunko TanakaEpidemiology, Infectious Disease Control and Prevention, Hiroshima University, Hiroshima, JapanJeffrey V. LazarusCUNY Graduate School of Public Health and Health Policy, New York City, United States; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, SpainDaniel Low‐BeerGlobal Hepatitis Programme, World Health Organization, Geneva, SwitzerlandZaigham AbbasHepatogastroenterology, Dr. Ziauddin University Hospital, Karachi, PakistanAntoine Abou RachedInternal Medicine - Gastroenterology, Faculty of Medical Sciences, Lebanese University, Beirut, LebanonAlessio AghemoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Gastroenterology, Humanitas Research Hospital IRCCS, Rozzano, ItalyInka AhoInfectious Diseases, Helsinki University Hospital, Helsinki, FinlandUlus Salih AkarcaDepartment of Gastroenterology, Ege University, Medical School, Izmir, TurkeySaid A. Al‐BusafiMedicine, College of Medicine and Health Sciences, Sultan Qaboos University, AlKhoudh, OmanWaleed K. Al‐HamoudiDepartment of Medicine, King Saud University, Riyadh, Saudi ArabiaKhalid Al‐NaamaniInternal Medicine, Division of Gastroenterology and Hepatology, Armed Forces Hospital, Muscat, OmanAhmed Sabry AlaamaWorld Health Organization Regional Office for the Eastern Mediterranean, Cairo, EgyptManahil M AldarViral Hepatitis Control Program, Ministry of Health, Ryiadh, Saudi ArabiaMohammed AlghamdiGastroenterology Unit, Department of Medicine, King Fahad Military Medical Complex, Dhahran, Saudi ArabiaMónica Alonso GonzálezPAHO/WHO, Washington DC, United StatesHaleema AlserehiPublic Health, MOH, Riyadh, Saudi ArabiaAnil C. AnandGastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, IndiaTarik AsselahHepatology Department, Université de Paris-Cité, Hôpital Beaujon, AP-HP, INSERM UMR, Paris, FranceAbdullah M. AssiriPublic Health Department, Ministry of Health, Riyadh, Saudi ArabiaKostas AthanasakisDepartment of Public Health Policy, University of West Attica, Athens, GreeceRita AtugonzaMinistry of Health, Kampala, UgandaZiv Ben‐AriLiver Medicine Center of Excellence, Assuta medical Centers, Tel Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelThomas BergDivision of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, GermanyCarlos Eduardo Brandão‐MelloInternal Medicine & Gastroenterology, University of Rio de Janeiro, Rio de Janeiro, Brazil; Clinica de Doenças do Fígado, Rio de Janeiro, BrazilA. BrownDepartment of Hepatology, Imperial College Healthcare NHS Trust, London, United KingdomKimberly BrownDepartment of Medicine, Henry Ford Hospital, Detroit, United StatesRobert S. BrownMedicine, Weill Cornell Medicine, New York, United StatesPhilip BruggmannArud Centre for Addiction Medicine, Zürich, SwitzerlandMaurizia Rossana BrunettoClinical and Experimental Medicine, University of Pisa, Pisa, Italy; Hepatology Unit, University Hospital of Pisa, Pisa, ItalyMaría ButiLiver Unit, Hospital Universitari Vall d Hebron and CIBEREHD del Insituto Carlos III. Universidad Autonoma de Barcelona, Barcelona, SpainHugo CheinquerDepartment of Gastroenterology and Hepatology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, BrazilPeer Brehm ChristensenDepartment of Infectious Diseases, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, DenmarkVladimir ChulanovNational Medical Research Center of Phthisiopulmonology & Infectious Diseases, Moscow, Russia; Department of Infectious Diseases, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, RussiaLaura GarzaDepartment of Hepatology, Hospital Christus Muguerza Alta Especialidad, Monterrey, MexicoCarla S. CoffinMedicine / Microbiology and Infectious Diseases Department, Cumming School of Medicine, University of Calgary, Calgary, CanadaNicola CoppolaMental health and Public medicine, University of Campania, Naples, ItalyAntonio Craxı̀PROMISE, School of Medicine, University of Palermo, Palermo, ItalyJavier CrespoGastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain; School of Medicine, University of Cantabria, Santander, SpainFuqiang CuiSchool of Public Health, Peking University, Beijing, China's MainlandOlav DalgårdDepartment of Infectious Diseases, Akershus University Hospital, Lørenskog, NorwayAlethse de la TorreVictor de LédinghenService d'hepatologie et de transplantation hepatique, CHU, Bordeaux, FranceDouglas T. DieterichInstitute for Liver Medicine, Icahn School of Medicine at Mount Sinai, New York, United StatesSylvia Dražilová2nd Dept of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Kosice, SlovakiaJean‐François DufourMohamed El‐KassasEndemic Medicine Department, Helwan University, Cairo, EgyptMohammed ElbadriGastroenterology Department, Hamad Medical Corporation, Doha, QatarGamal EsmatEndemic medicine department, Cairo University Hospitals, Cairo, EgyptRafael Esteban MurDepartment of Hepatology, Hospital Universitario Vall d'Hebron, Barcelona, SpainBrandon EurichCenter for Disease Analysis Foundation, Lafayette, United StatesDiana FainiGlobal Hepatitis Programme, WHO, Geneva, SwitzerlandPaulo Roberto Abrão FerreiraDivision of Infectious Disease, Federal University of São Paulo, São Paulo, BrazilRobert FlisiakDepartment of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, PolandSoňa FraňkováDepartment of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, CzechiaGiovanni Battista GaetaIvane GamkrelidzeCenter for Disease Analysis Foundation, Lafayette, United StatesEdward GaneNew Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New ZealandVirginia GarciaGastroenterology Professor at Universidad Autonoma de Santo Domingo / Doctor at Centro Endoscopico Digestivo Integral / Retire doctor from the Health Ministry in the Dominican Republic, Santo Domingo, Dominican RepublicJavier García‐SamaniegoLiver Unit, Hospital Universitario La Paz, CIBERehd/IdiPAZ. Universidad Autónoma de Madrid, Madrid, SpainManik GemilyanDepartment of Gastroenterology and Hepatology, Yerevan State Medical University, Yerevan, ArmeniaMagnús GottfreðssonDepartments of science and infectious diseases, Landspitali University Hospital, Reykjavík, Iceland; Faculty of Medicine, University of Iceland, Reykjavík, IcelandMichael GschwantlerDepartment of Internal Medicine IV, Klinik Ottakring, Vienna, Austria; Sigmund Freud University, Vienna, AustriaAna Paula Maciel GurskiDepartment of HIV/Aids, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections, Ministry of Health, Brasilia, BrazilBehzad HajarizadehThe Kirby Institute, UNSW, Sydney, AustraliaSaeed HamidMedicine, Aga Khan University, Karachi, PakistanAngelos HatzakisDepartment of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, GreeceJulian HercunLiver Unit, Centre hospitalier de l'Universite de Montreal, Montreal, CanadaIvana HockickováDepartment of Infectology and Travel Medicine, P.J. Safarik University, Faculty of Medicine and L. Pasteur University Hospital, Kosice, SlovakiaJee‐Fu HuangHepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanBéla HunyadyDivision of Gastroenterology, First Department of Medicine, Clinical Centre, University of Pecs, Budapest, HungarySharon HutchinsonSchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom; Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, United KingdomNaoko IshikawaGlobal Hepatitis Programme, World Health Organization, Geneva, SwitzerlandKiyohiko IzumiDivision of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, PhilippinesAntonio IzziDepartment of Infectious Diseases and Emergency Infectious Disease, Division of Highly Contagious Infections Diseases, "D. Cotugno" hospital, Naples, ItalyMartin Janíčko2nd Dept of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Kosice, SlovakiaPeter Jarčuška2nd Dept of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Kosice, SlovakiaAgita JērumaRiga East University hospital, Riga, Latvia; Faculty of Medicine, Riga Stradins University, Riga, LatviaAsgeir JohannessenVestfold Hospital Trust, Tonsberg, NorwayKulpash KaliaskarovaNational Research Oncology Center, Astana, KazakhstanJia‐Horng KaoHepatitis Research Center , National Taiwan University Hospital, Taipei, TaiwanKnut Boe KiellandResearch Center for Substance Use Disorders and Mental Illness, Innlandet Hospital Trust, Brumunddal, NorwayNicolas KodjohFaculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou, BeninShyamasundaran KottililInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, United StatesPavol KristiánDepartment of Infectology and Travel Medicine, P.J. Safarik University, Faculty of Medicine and L. Pasteur University Hospital, Kosice, SlovakiaPaul Y. KwoMedicine, Stanford University School of Medicine, Redwood City, United StatesMartin LaggingDepartment of Infectious Diseases / Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, SwedenHilton Y. LamInstitute of Health Policy and Development Studies, University of the Philippines, Manila, PhilippinesPablo LázaroIndependent Health Services Researcher, Madrid, SpainMei‐Hsuan LeeInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanSabela LensLiver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, CIBERehd, Barcelona, SpainValentina LiakinaClinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania; Department of Chemistry and Bioengineering, VILNIUS TECH, Faculty of Fundamental Sciences, Vilnius, LithuaniaYoung‐Suk LimGastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic ofMichael MakaraCentral Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, HungaryM.P. MannsDept. of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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BACKGROUND & AIMS: The year 2023 marked the 10-year anniversary of the launch of direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV). Monitoring HCV treatment trends by country, region, and globally is important to assess progress toward the World Health Organization's 2030 elimination targets. Additionally, historical patterns can help predict the uptake of future therapies for other liver diseases. METHODS: The number of people living with HCV (PLHCV) treated between 2014-2023 across 119 countries was estimated using national HCV registries, reported DAA sales data, pharmaceutical companies' reports, and estimates provided by national experts. For the countries with no available data, the average estimate of the corresponding Global Burden of Disease region was used. RESULTS: An estimated 13,816,000 (95% uncertainty intervals: 13,221,000-16,415,000) PLHCV were treated, of whom 12,748,000 (12,226,000-15,231,000) were treated with DAAs, of which 11,081,000 (10,542,000-13,338,000) were sofosbuvir-based DAA regimens. Country-level data accounted for 97% of these estimates. In high-income countries, there was a 41% drop in treatment from its peak, and reimbursement was a large predictor of treatment. In low- and middle-income countries, price played an important role in expanding treatment access through the public and private markets, and treatment continues to increase slowly after a sharp drop at the end of the Egyptian national program. CONCLUSIONS: In the last 10 years, 21% of all HCV infections were treated with DAAs. Regional and temporal variations highlight the importance of active screening strategies. Without program enhancements, the number of treated PLHCV stalled in every country/region, which may not reflect a lower prevalence but may instead reflect the diminishing returns of existing strategies. IMPACT AND IMPLICATIONS: Long-term hepatitis C virus (HCV) infection can lead to cirrhosis and liver cancer. Since 2014, these infections can be effectively treated with 8-12 weeks of oral therapies. In 2015, the World Health Organization established targets to eliminate HCV by 2030, which included treatment targets for member countries. The current study examines HCV treatment patterns across 119 countries and regions from 2014 to 2023 to assess the impact of national programs. This study can assist physicians and policymakers in understanding treatment patterns within similar regions or income groups and in utilizing historical data to refine their strategies in the future.
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