Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPFERREIRA, Paulo Roberto AbraoBRANDAO-MELLO, Carlos EduardoESTES, ChrisGONCALES JUNIOR, Fernando LopesCOELHO, Henrique Sergio MoraesRAZAVI, HomieCHEINQUER, HugoWOLFF, Fernando HerzFERRAZ, Maria Lucia GomesPESSOA, Mario GuimardesMENDES-CORREA, Maria Cassia2015-10-262015-10-262015BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, v.19, n.4, p.363-368, 20151413-8670https://observatorio.fm.usp.br/handle/OPI/11675Background: Hepatitis C virus infection is a major cause of cirrhosis; hepatocellular carcinoma; and liver transplantation. The aim of this study was to estimate hepatitis C virus disease progression and the burden of disease from a nationwide perspective. Methods: Using a model developed to forecast hepatitis C virus disease progression and the number of cases at each stage of liver disease; hepatitis C virus-infected population and associated disease progression in Brazil were quantified. The impact of two different strategies was compared: higher sustained virological response and treatment eligibility rates (1) or higher diagnosis and treatment rates associated with increased sustained virological response rates (2). Results: The number of infected individuals is estimated to decline by 35% by 2030 (1,255,000 individuals); while the number of cases of compensated (n =325,900) and decompensated (n=45,000) cirrhosis; hepatocellular carcinoma (n=19,100); and liver-related deaths (n=16,700) is supposed to peak between 2028 and 2032. In strategy 2; treated cases increased over tenfold in 2020 (118,800 treated) as compared to 2013 (11,740 treated); with sustained virological response increased to 90% and treatment eligibility to 95%. Under this strategy; the number of infected individuals decreased by 90% between 2013 and 2030. Compared to the base case; liver-related deaths decreased by 70% by 2030; while hepatitis C virus-related liver cancer and decompensated cirrhosis decreased by 75 and 80%; respectively. Conclusions: While the incidence and prevalence of hepatitis C virus in Brazil are decreasing; cases of advanced liver disease continue to rise. Besides higher sustained virological response rates; new strategies focused on increasing the proportion of diagnosed patients and eligibility to treatment should be adopted in order to reduce the burden of hepatitis C virus infection in Brazil.engopenAccessHCVDisease burdenEpidemiologyIncidenceBrazilhcv infectionfollow-upmortalitycohortsurvivalribavirinaddictslondonusersdeatharticleCopyright ELSEVIER SCIENCE BV10.1016/j.bjid.2015.04.004Infectious Diseases1678-4391