MARIO GUIMARAES PESSOA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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Agora exibindo 1 - 7 de 7
- Anti-mitochondrial Antibody-Negative Primary Biliary Cholangitis Is Part of the Same Spectrum of Classical Primary Biliary Cholangitis(2022) CANCADO, Guilherme Grossi Lopes; BRAGA, Michelle Harriz; FERRAZ, Maria Lucia Gomes; VILLELA-NOGUEIRA, Cristiane Alves; TERRABUIO, Debora Raquel Benedita; CANCADO, Eduardo Luiz Rachid; NARDELLI, Mateus Jorge; FARIA, Luciana Costa; GOMES, Nathalia Mota de Faria; OLIVEIRA, Elze Maria Gomes; ROTMAN, Vivian; OLIVEIRA, Maria Beatriz; CUNHA, Simone Muniz Carvalho Fernandes da; CUNHA-SILVA, Marlone; MENDES, Liliana Sampaio Costa; IVANTES, Claudia Alexandra Pontes; CODES, Liana; BORGES, Valeria Ferreira; PACE, Fabio Heleno de Lima; PESSOA, Mario Guimaraes; SIGNORELLI, Izabelle Venturini; CORAL, Gabriela Perdomo; BITTENCOURT, Paulo Lisboa; LEVY, Cynthia; COUTO, Claudia AlvesBackground Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease in which anti-mitochondrial antibodies (AMA) are the diagnostic hallmark. Whether AMA-negative PBC patients represent a different phenotype of disease is highly debated. Aims The purpose of our study was to compare AMA-positive and AMA-negative PBC patients in a large non-white admixed Brazilian cohort. Methods The Brazilian Cholestasis Study Group multicentre database was reviewed to assess demographics, clinical features and treatment outcomes of Brazilian PBC patients, stratifying data according to AMA status. Results A total of 464 subjects (95.4% females, mean age 56 +/- 5 years) with PBC were included. Three hundred and eighty-four (83%) subjects were AMA-positive, whereas 80 (17%) had AMA-negative PBC. Subjects with AMA-negative PBC were significantly younger (52.2 +/- 14 vs. 59.6 +/- 11 years, p = 0.001) and had their first symptom at an earlier age (43.2 +/- 13 vs. 49.5 +/- 12 years, p = 0.005). Frequency of type 2 diabetes was significantly increased in subjects with AMA-negative PBC (22.5% vs. 12.2%, p = 0.03). Lower IgM (272.2 +/- 183 vs. 383.2 +/- 378 mg/dL, p = 0.01) and triglycerides (107.6 +/- 59.8 vs.129.3 +/- 75.7 mg/dL, p = 0.025) and higher bilirubin (3.8 +/- 13.5 vs. 1.8 +/- 3.4 mg/dL, p = 0.02) levels were also observed in this subgroup. Response to ursodeoxycholic acid varied from 40.5 to 63.3% in AMA-positive and 34 to 62.3% in AMA-negative individuals, according to different response criteria. Outcomes such as development of liver-related complications, death and requirement for liver transplantation were similar in both groups. Conclusions AMA-negative PBC patients are similar to their AMA-positive counterparts with subtle differences observed in clinical and laboratory features.
- Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil(2022) LOURENCO, Mariana Sandoval; ZITELLI, Patricia Momoyo Y.; CUNHA-SILVA, Marlone; OLIVEIRA, Arthur Ivan N.; OLIVEIRA, Claudia P.; SEVA-PEREIRA, Tiago; CARRILHO, Flair Jose; PESSOA, Mario G.; MAZO, Daniel F.BACKGROUND Hepatitis C virus (HCV) treatment has undergone major changes in recent years. Previous interferon-based therapies have been replaced by oral direct-acting antivirals (DAA) regimens, with high sustained virologic response (SVR) rates, and a lower incidence of adverse events (AEs). AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in Brazil. METHODS This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C (CHC), undergoing treatment with interferon-free regimens from November 2015 to November 2019. The therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of treatment. Demographic, anthropometric, clinical, and laboratory variables were evaluated. SVRs were assessed at 12 to 24 wk after therapy by intention-to-treat (ITT), and modified ITT (m-ITT) analysis. AEs and serious adverse events (SAEs) were registered. In the statistical analysis, a P value of < 0.05 was considered significant. RESULTS The mean age was 56.88 years, with 415 (78.5%) being HCV genotype 1, followed by genotype 3 (20.1%). Moreover, 306 (57.5%) subjects had cirrhosis, and a third of them had decompensated cirrhosis. Sofosbuvir (SOF) plus daclatasvir ribavirin was the most frequently used treatment (66.9%), followed by SOF plus simeprevir (21.2%). The overall ITT SVR was 92.6% (493/532), while the m-ITT SVR was 96.8% (493/509). Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy (OR: 4.320; 95%CI: 1.920-9.721, P = 0.0004), presence of esophageal varices (OR: 2.381; 95%CI: 1.137-4.988, P = 0.0215), previous portal hypertensive bleeding (OR: 2.756; 95%CI: 1.173-6.471, P = 0.02), higher model for end-stage liver disease scores (OR: 1.143, 95%CI: 1.060-1.233, P = 0.0005), lower serum albumin levels (OR: 0.528, 95%CI: 0.322-0.867, P = 0.0115), higher serum creatinine (OR: 1.117, 95%CI: 1.056-1.312, P = 0.0033), and international normalized ratio (INR) levels (OR: 5.542, 95%CI: 2.023-15.182, P = 0.0009). AEs were reported in 41.1% (211/514) of patients, and SAEs in 3.7%. The female gender, higher body mass index, esophageal varices, higher INR values, and longer treatment duration were independently associated with AE occurrence. CONCLUSION Treatment with oral DAAs attains a high SVR rate, with fewer SAEs in a real-life cohort of subjects with CHC, from two tertiary university centers in Brazil.
- National Brazilian survey on the outcomes of hepatitis c retreatment in patients non-responders to direct antiviral agents(2022) FERRAZ, Maria Lucia Gomes; PICCOLI, Leonora de Zorzi; REZENDE, Rosamar; BORBA, Luiz Augusto; PISSAIA JUNIOR, Alcindo; CHEINQUER, Hugo; SILVA, Giovanni Faria; FERREIRA, Paulo Roberto Abrao; VILLELA-NOGUEIRA, Cristiane Alves; MAZO, Daniel Ferraz; SOUZA, Fernanda Fernandes; CODES, Liana; IVANTES, Claudia Alexandra Pontes; GOMIDE, Geisa Perez Medina; PEREIRA, Gustavo Henrique Santos; PESSOA, Mario Guimaraes; FRANCA, Alex Vianey Callado; PINTO, Arlene dos Santos; TEIXEIRA, Rosangela; BITTENCOURT, Paulo LisboaBackground and aims: Treatment of hepatitis C with direct antiviral agents (DAA) is associ-ated with almost 95% of sustained virological response. However, some patients need retreatment. In Brazil, it should be done according to the Ministry of Health guidelines, fre-quently updated to include newly available drugs. This study aimed to conduct a national survey about the characteristics and outcomes of retreatment of hepatitis C in previously non-responders to DAAs. Patients and methods: Institutions from all over the country were invited to participate in a national registry for retreatment, including information about clinical and epidemiological characteristics of the patients, type and outcomes of retreatment regimens. Only patients previously treated with interferon-free regimens were included. Results: As previous treatments the distribution was: SOF/DCV (56%), SOF/SIM (22%), 3D (11%), SOF/LED (6%) and SOF/RBV (5%). For retreatment the most frequently used drugs were SOF/GP (46%), SOF/DCV (23%) and SOF/VEL (11%). From 159 patients retreated, 132/159 (83%) had complete information in the registry and among them only seven patients were non-responders (SVR of 94.6%). All retreatments were well tolerated, without any serious adverse events or interruptions. Conclusion: The retreatment of patients previously non-responders to DAAs was associated with high rate of SVR in this sample of Brazilian patients. This finding allows us to conclude that the retreatment options available in the public health system in Brazil are effective and safe and are an important component of the strategy of elimination of hepatitis C in our country. (c) 2022 Sociedade Brasileira de Infectologia.
- Fibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study(2022) CANCADO, Guilherme Grossi Lopes; COUTO, Claudia Alves; GUEDES, Laura Vilar; BRAGA, Michelle Harriz; TERRABUIO, Debora Raquel Benedita; CANCADO, Eduardo Luiz Rachid; FERRAZ, Maria Lucia Gomes; VILLELA-NOGUEIRA, Cristiane Alves; NARDELLI, Mateus Jorge; FARIA, Luciana Costa; OLIVEIRA, Elze Maria Gomes de; ROTMAN, Vivian; MAZO, Daniel Ferraz de Campos; BORGES, Valeria Ferreira de Almeida e; MENDES, Liliana Sampaio Costa; CODES, Liana; PESSOA, Mario Guimaraes; SIGNORELLI, Izabelle Venturini; LEVY, Cynthia; BITTENCOURT, Paulo LisboaAim: Up to 40% of patients with primary biliary cholangitis (PBC) will have a suboptimal biochemical response to ursodeoxycholic acid (UDCA), which can be improved by the addition of fibrates. This exploratory study aims to evaluate the long-term real-life biochemical response of different fibrates, including ciprofibrate, in subjects with UDCA-unresponsive PBC.Methods: The Brazilian Cholestasis Study Group multicenter database was reviewed to assess the response rates to UDCA plus fibrates in patients with UDCA-unresponsive PBC 1 and 2 years after treatment initiation by different validated criteria.Results: In total, 27 patients (100% women, mean age 48.9 +/- 9.2 years) with PBC were included. Overall response rates to fibrates by each validated criterion varied from 39 to 60% and 39-76% at 12 and 24 months after treatment combination, respectively. Combination therapy resulted in a significant decrease in ALT and ALP only after 2 years, while GGT significantly improved in the first year of treatment. Treatment response rates at 1 and 2 years appear to be comparable between ciprofibrate and bezafibrate using all available criteria.Conclusion: Our findings endorse the efficacy of fibrate add-on treatment in PBC patients with suboptimal response to UDCA. Ciprofibrate appears to be at least as effective as bezafibrate and should be assessed in large clinical trials as a possibly new, cheaper, and promising option for treatment of UDCA-unresponsive PBC patients.
- Clinical features and treatment outcomes of primary biliary cholangitis in a highly admixed population(2022) CANCADO, Guilherme Grossi Lopes; BRAGA, Michelle Harriz; FERRAZ, Maria Lucia Gomes; VILLELA-NOGUEIRA, Cristiane Alves; TERRABUIO, Debora Raquel Benedita; CANCADO, Eduardo Luiz Rachid; NARDELLI, Mateus Jorge; FARIA, Luciana Costa; GOMES, Nathalia Mota de Faria; OLIVEIRA, Elze Maria Gomes de; ROTMAN, Vivian; OLIVEIRA, Maria Beatriz de; CUNHA, Simone Muniz Carvalho Fernandes da; MAZO, Daniel Ferraz de Campos; MENDES, Liliana Sampaio Costa; IVANTES, Claudia Alexandra Pontes; CODES, Liana; BORGES, Valeria Ferreira de Almeida e; PACE, Fabio Heleno de Lima; PESSOA, Mario Guimaraes; SIGNORELLI, Izabelle Venturini; CORAL, Gabriela Perdomo; BITTENCOURT, Paulo Lisboa; LEVY, Cynthia; COUTO, Claudia AlvesIntroduction and objectives: Little is known about primary biliary cholangitis (PBC) in non-whites. The purpose of this study was to evaluate clinical features and outcomes of PBC in a highly admixed population. Material and methods: The Brazilian Cholestasis Study Group multicentre database was reviewed to assess demographics, clinical features and treatment outcomes of Brazilian patients with PBC. Results: 562 patients (95% females, mean age 51 +/- 11 years) with PBC were included. Concurrent autoimmune diseases and overlap with autoimmune hepatitis (AIH) occurred, respectively, in 18.9% and 14%. After a mean follow-up was 6.2 +/- 5.3 years, 32% had cirrhosis, 7% underwent liver transplantation and 3% died of liver-related causes. 96% were treated with ursodeoxycholic acid (UDCA) and 12% required add-on therapy with fibrates, either bezafibrate, fenofibrate or ciprofibrate. Response to UDCA and to UDCA/fibrates therapy varied from 39%-67% and 42-61%, respectively, according to different validated criteria. Advanced histologi -cal stages and non-adherence to treatment were associated with primary non-response to UDCA, while lower baseline alkaline phosphatase (ALP) and aspartate aminotransferase (AST) levels correlated with better responses to both UDCA and UDCA/fibrates. Conclusions: Clinical features of PBC in highly admixed Brazilians were similar to those reported in Cauca-sians and Asians, but with inferior rates of overlap syndrome with AIH. Response to UDCA was lower than expected and inversely associated with histological stage and baseline AST and ALP levels. Most of patients benefited from add-on fibrates, including ciprofibrate. A huge heterogeneity in response to UDCA therapy according to available international criteria was observed and reinforces the need of global standardization. (c) 2021 Fundacion Clinica Medica Sur, A.C.
- Executive Summary of the KDIGO 2022 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease(2022) MARTIN, Paul; AWAN, Ahmed A.; BERENGUER, Marina C.; BRUCHFELD, Annette; FABRIZI, Fabrizio; GOLDBERG, David S.; JIA, Jidong; KAMAR, Nassim; MOHAMED, Rosmawati; PESSOA, Mario Guimaraes; POL, Stanislas; SISE, Meghan E.; BALK, Ethan M.; GORDON, Craig E.; ADAM, Gaelen; CHEUNG, Michael; EARLEY, Amy; JADOUL, MichelInfection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy or with a kidney transplant. Since the publication of the Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2018, advances in HCV management, particularly in the field of antiviral therapy and treatment of HCV-associated glomerular diseases, coupled with increased usage of HCV-positive kidney grafts, have prompted a reexamination of the 2018 guideline. As a result, the Work Group performed a comprehensive review and revised the 2018 guidance. This Executive Summary highlights key aspects of the updated guideline recommendations for 3 chapters: Chapter 2: Treatment of HCV infection in patients with CKD; Chapter 4: Management of HCV-infected patients before and after kidney transplantation; and Chapter 5: Diagnosis and management of kidney diseases associated with HCV infection.
- Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study(2022) BLACH, Sarah; TERRAULT, Norah A.; TACKE, Frank; GAMKRELIDZE, Ivane; CRAXI, Antonio; TANAKA, Junko; WAKED, Imam; DORE, Gregory J.; ABBAS, Zaigham; ABDALLAH, Ayat R.; ABDULLA, Maheeba; AGHEMO, Alessio; AHO, Inka; AKARCA, Ulus S.; ALALWAN, Abduljaleel M.; BLOME, Marianne Alanko; AL-BUSAFI, Said A.; ALEMAN, Soo; ALGHAMDI, Abdullah S.; AL-HAMOUDI, Waleed K.; ALJUMAH, Abdulrahman A.; AL-NAAMANI, Khalid; SERKAL, Yousif M. Al; ALTRAIF, Ibrahim H.; ANAND, Anil C.; ANDERSON, Motswedi; I, Monique Andersson; ATHANASAKIS, Kostas; BAATARKHUU, Oidov; BAKIEVA, Shokhista R.; BEN-ARI, Ziv; BESSONE, Fernando; BIONDI, Mia J.; BIZRI, Abdul Rahman N.; MELLO, Carlos E. Brandaoo; BRIGIDA, Krestina; BROWN, Kimberly A.; BROWN JR., Robert S.; BRUGGMANN, Philip; BRUNETTO, Maurizia R.; BUSSCHOTS, Dana; BUTI, Maria; BUTSASHVILI, Maia; CABEZAS, Joaquin; CHAE, Chungman; IVANOVA, Viktorija Chaloska; CHAN, Henry Lik Yuen; CHEINQUER, Hugo; CHENG, Kent Jason; CHEON, Myeong Eun; CHIEN, Cheng Hung; CHIEN, Rong Nan; CHOUDHURI, Gourdas; CHRISTENSEN, Peer Brehm; CHUANG, Wan Long; CHULANOV, Vladimir; CISNEROS, Laura E.; COCO, Barbara; CONTRERAS, Fernando A.; CORNBERG, Markus; CRAMP, Matthew E.; CRESPO, Javier; CUI, Fuqiang; CUNNINGHAM, Chris W.; ABOU, Lucy Dagher; DALGARD, Olav; DAO, Doan Y.; LEDINGHEN, Victor De; DERBALA, Moutaz F.; DEUBA, Keshab; DHINDSA, Karan; DJAUZI, Samsuridjal; DRAZILOVA, Sylvia; DUBERG, Ann Sofi; ELBADRI, Mohammed; EL-SAYED, Manal H.; ESMAT, Gamal; ESTES, Chris; EZZAT, Sameera; FARKKILA, Martti A.; FERRADINI, Laurent; FERRAZ, Maria Lucia G.; FERREIRA, Paulo R. Abrao; KANIZAJ, Tajana Filipec; FLISIAK, Robert; FRANKOVA, Sona; FUNG, James; GAMKRELIDZE, Amiran; GANE, Edward J.; GARCIA, Virginia; GARCIA-SAMANIEGO, Javier; GEMILYAN, Manik; GENOV, Jordan; GHEORGHE, Liliana S.; GHOLAM, Pierre M.; NULL, Adrian Goldis; GOTTFREDSSON, Magnus; GRAY, Richard T.; GREBELY, Jason; GSCHWANTLER, Michael; HAJARIZADEH, Behzad; HAMID, Saeed S.; HAMOUDI, Waseem; HATZAKIS, Angelos; HELLARD, Margaret E.; HIMATT, Sayed; HOFER, Harald; HRSTIC, Irena; HUNYADY, Bela; HUSA, Petr; HUSIC-SELIMOVIC, Azra; JAFRI, Wasim S. M.; JANICKO, Martin; JANJUA, Naveed Z.; JARCUSKA, Peter; JAROSZEWICZ, Jerzy; JERKEMAN, Anna; JERUMA, Agita; JIA, Jidong; JONASSON, Jon G.; KABERG, Martin; KAITA, Kelly D. E.; NULL, Kulpash S. Kaliaskarova; KAO, Jia Horng; KASYMOV, Omor T.; HANKU, Angela Kelly; KHAMIS, Faryal; KHAMIS, Jawad; KHAN, Aamir G.; KHANDU, Lekey; KHOUDRI, Ibtissam; KIELLAND, Knut B.; KIM, Do Young; KODJOH, Nicolas; KONDILI, Loreta A.; KRAJDEN, Mel; KRARUP, Henrik Bygum; KRISTIAN, Pavol; KWON, Jisoo A.; LAGGING, Martin; LALEMAN, Wim; LAO, Wai Cheung; LAVANCHY, Daniel; LAZARO, Pablo; V, Jeffrey Lazarus; LEE, Alice U.; LEE, Mei Hsuan; LI, Michael K. K.; LIAKINA, Valentina; LIM, Young Suk; LOVE, Arthur; LUKSIC, Boris; MACHEKERA, Shepherd Mufudzi; MALU, Abraham O.; MARINHO, Rui T.; MATICIC, Mojca; MEKONNEN, Hailemichael D.; MENDES-CORREA, Maria Cassia; MENDEZ-SANCHEZ, Nahum; MERAT, Shahin; MESHESHA, Berhane Redae; MIDGARD, Havard; MILLS, Mike; MOHAMED, Rosmawati; MOONEYHAN, Ellen; MORENO, Christophe; MULJONO, David H.; MULLHAUPT, Beat; MUSABAEV, Erkin; MUYLDERMANS, Gaetan; NARTEY, Yvonne Ayerki; NAVEIRA, Marcelo C. M.; NEGRO, Francesco; V, Alexander Nersesov; NJOUOM, Richard; NTAGIRABIRI, Renovat; NURMATOV, Zuridin S.; OBEKPA, Solomon A.; OGUCHE, Stephen; OLAFSSON, Sigurdur; ONG, Janus P.; OPARE-SEM, Ohene K.; ORREGO, Mauricio; OVREHUS, Anne L.; PAN, Calvin Q.; V, George Papatheodoridis; PECK-RADOSAVLJEVIC, Markus; PESSOA, Mario G.; PHILLIPS, Richard O.; PIMENOV, Nikolay; PLASESKA-KARANFILSKA, Dijana; PRABDIAL-SING, Nishi N.; PURI, Pankaj; NULL, Huma Qureshi; RAHMAN, Aninda; RAMJI, Alnoor; RAZAVI-SHEARER, Devin M.; RAZAVI-SHEARER, Kathryn; RIDRUEJO, Ezequiel; RIOS-HINCAPIE, Cielo Y.; RIZVI, S. M. Shahriar; ROBAEYS, Geert K. M. M.; ROBERTS, Lewis R.; ROBERTS, Stuart K.; RYDER, Stephen D.; SADIROVA, Shakhlo; SAEED, Umar; SAFADI, Rifaat; SAGALOVA, Olga; SAID, Sanaa S.; SALUPERE, Riina; SANAI, Faisal M.; SANCHEZ-AVILA, Juan F.; SARASWAT, Vivek A.; SARRAZIN, Christoph; SARYBAYEVA, Gulya; SEGUIN-DEVAUX, Carole; I, Ala Sharara; SHEIKH, Mahdi; SHEWAYE, Abate B.; SIEVERT, William; SIMOJOKI, Kaarlo; SIMONOVA, Marieta Y.; SONDERUP, Mark W.; SPEARMAN, C. Wendy; SPERL, Jan; STAUBER, Rudolf E.; STEDMAN, Catherine A. M.; SU, Tung Hung; SULEIMAN, Anita; SYPSA, Vana; ANTABAK, Natalia Tamayo; TAN, Soek Siam; TERGAST, Tammo L.; THURAIRAJAH, Prem H.; TOLMANE, Ieva; TOMASIEWICZ, Krzysztof; TSERETELI, Maia; UZOCHUKWU, Benjamin S. C.; VIJVER, David A. M. C. Van de; SANTEN, Daniela K. van; VLIERBERGHE, Hans Van; WELZEN, Berend Van; VANWOLLEGHEM, Thomas; VELEZ-MOLLER, Patricia; VILLAMIL, Federico Guillermo; VINCE, Adriana; WAHEED, Yasir; WEIS, Nina; WONG, Vincent W. S.; YAGHI, Cesar G.; YESMEMBETOV, Kakharman; YOSRY, Ayman; YUEN, Man Fung; YUNIHASTUTI, Evy; ZEUZEM, Stefan; ZUCKERMAN, Eli; RAZAVI, Homie A.Background Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age =0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0.7% (95% UI 0.7-0.9), corresponding to 56.8 million (95% UI 55.2-67.8) infections, on Jan 1, 2020. This number represents a decrease of 6.8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63.6 million (61.8-75.8) infections (0.9% [0.8-1.0] prevalence). By the end of 2020, an estimated 12.9 million (12.5-15.4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. Interpretation At the beginning of 2020, there were an estimated 56.8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination.