Hepatitis C disease burden and strategies for elimination by 2030 in Brazil. A mathematical modeling approach
Carregando...
Citações na Scopus
35
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER BRAZIL
Autores
BENZAKEN, Adele Schwartz
GIRADE, Renato
CATAPAN, Elisa
PEREIRA, Gerson Fernando Mendes
ALMEIDA, Elton Carlos de
VIVALDINI, Simone
FERNANDES, Neide
RAZAVI, Homie
SCHMELZER, Jonathan
FERRAZ, Maria Lucia
Citação
BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, v.23, n.3, p.182-190, 2019
Resumo
Introduction and aim: Hepatitis C is a key challenge to public health in Brazil. The objective of this paper was to describe the Brazilian strategy for hepatitis C to meet the 2030 elimination goal proposed by World Health Organization (WHO). Methods: A mathematical modeling approach was used to estimate the current HCV-infected Brazilian population, and to evaluate the relative costs of two different scenarios to address HCV disease burden in Brazil: (1) if no further changes are made to the HCV treatment program in Brazil; (2) where the WHO targets for 2030 elimination are met through diagnosis and treatment efforts peaking before 2024. Results: An anti-HCV prevalence of 0.53% was calculated for the total population. It was estimated that the number of HCV-RNA+ individuals in Brazil in 2017 was 632,000 (0.31% of the population). Scale-up of treatment and diagnosis over time will be necessary in order to achieve WHO targets beginning in 2018. Direct costs (diagnostic, treatment and healthcare costs) are projected to increase significantly during the scale-up of treatment and diagnosis in the initial years of the intervention scenario, but then fall below the base case on an annual basis by 2025-2036, once HCV is eliminated, due to health sectors savings from the prevention of HCV liver-related morbidity and mortality. Conclusion: Achieving the WHO targets is technically feasible in Brazil with a scale-up of treatment and diagnosis over time, beginning in 2018. However, elimination of hepatitis C requires policy changes to substantially scale-up prevention, screening and treatment of HCV, together with public health advocacy to raise awareness among affected populations and healthcare providers. (C) 2019 Sociedade Brasileira de Infectologia.
Palavras-chave
Hepatitis C, Hepatitis C elimination, Hepatitis C disease burden, Brazil
Referências
- [Anonymous], B EP HEP VIR
- [Anonymous], B EP HEP VIR, V49
- Bittencourt PL, 2016, LIVER TRANSPLANT, V22, P1254, DOI 10.1002/lt.24487
- Blach S, 2017, LANCET GASTROENTEROL, V2, P161, DOI 10.1016/S2468-1253(16)30181-9
- Brasil, 2017, 4 B PROD HEM HEM 201
- Brasil. Ministerio da Saude, 2018, EST EP PREV INF SIF
- Bruggmann P, 2014, J VIRAL HEPATITIS, V21, P5, DOI 10.1111/jvh.12247
- Carvalho-Filho RJ, 2015, WORLD J GASTROENTERO, V21, P408, DOI 10.3748/wjg.v21.i2.408
- Chaves GC, 2017, CIENC SAUDE COLETIVA, V22, P2527, DOI 10.1590/1413-81232017228.05602017
- Costi C, 2017, MEM I OSWALDO CRUZ, V112, P255, DOI 10.1590/0074-02760160352
- Kretzer IF, 2014, SCI WORLD J, DOI 10.1155/2014/827849
- Magri MC, 2015, REV SAUDE PUBL, V49, DOI 10.1590/S0034-8910.2015049005886
- Marques BC, 2015, PLOS ONE
- Mesquita F, 2016, BMC PUBLIC HEALTH, V16, DOI 10.1186/s12889-016-3784-4
- Puga MAM, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0169195
- da Silva NMO, 2013, VIROL J, V10, DOI 10.1186/1743-422X-10-167
- Oliveira MLA, 2009, EPIDEMIOL INFECT, V137, P970, DOI 10.1017/S0950268808001970
- Pereira LMMB, 2013, BMC INFECT DIS, V13, DOI 10.1186/1471-2334-13-60
- Pinto FPD, 2015, ANN HEPATOL, V14, P815, DOI 10.5604/16652681.1171756
- Silva MBS, 2010, MEM I OSWALDO CRUZ, V105, P299, DOI 10.1590/S0074-02762010000300009
- Toledo Jr. Antonio C., 2005, Braz J Infect Dis, V9, P374, DOI 10.1590/S1413-86702005000500004
- Vos T, 2017, LANCET, V390, P1211, DOI 10.1016/S0140-6736(17)32154-2
- World Health Organization, 2016, COMB HEP B C REACH E