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Curbing the Hepatitis C virus epidemic in Pakistan: the impact of scaling up treatment and prevention for achieving elimination

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Curbing the Hepatitis C virus epidemic in Pakistan : the impact of scaling up treatment and prevention for achieving elimination. / Lim, Aaron G; Qureshi, Huma; Mahmood, Hassan; Hamid, Saeed; Davies, Charlotte F; Trickey, Adam; Glass, Nancy; Saeed, Quaid; Fraser, Hannah; Walker, Josephine G; Mukandavire, Christinah; Hickman, Matthew; Martin, Natasha K; May, Margaret T; Averhoff, Francisco; Vickerman, Peter.

In: International Journal of Epidemiology, 03.01.2018.

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Lim, Aaron G ; Qureshi, Huma ; Mahmood, Hassan ; Hamid, Saeed ; Davies, Charlotte F ; Trickey, Adam ; Glass, Nancy ; Saeed, Quaid ; Fraser, Hannah ; Walker, Josephine G ; Mukandavire, Christinah ; Hickman, Matthew ; Martin, Natasha K ; May, Margaret T ; Averhoff, Francisco ; Vickerman, Peter. / Curbing the Hepatitis C virus epidemic in Pakistan : the impact of scaling up treatment and prevention for achieving elimination. In: International Journal of Epidemiology. 2018.

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@article{73e40134687e4498b4caccc3c5f418f8,
title = "Curbing the Hepatitis C virus epidemic in Pakistan: the impact of scaling up treatment and prevention for achieving elimination",
abstract = "BackgroundThe World Health Organization (WHO) has developed a global health strategy to eliminate viral hepatitis. We project the treatment and prevention requirements to achieve the WHO HCV elimination target of reducing HCV incidence by 80{\%} and HCV-related mortality by 65{\%} by 2030 in Pakistan, which has the second largest HCV burden worldwide.MethodsWe developed an HCV transmission model for Pakistan, and calibrated it to epidemiological data from a national survey (2007), surveys among people who inject drugs (PWID), and blood donor data. Current treatment coverage data came from expert opinion and published reports. The model projected the HCV burden, including incidence, prevalence and deaths through 2030, and estimated the impact of varying prevention and direct-acting antiviral (DAA) treatment interventions necessary for achieving the WHO HCV elimination targets.ResultsWith no further treatment (currently ∼150 000 treated annually) during 2016–30, chronic HCV prevalence will increase from 3.9{\%} to 5.1{\%}, estimated annual incident infections will increase from 700 000 to 1 100 000, and 1 400 000 HCV-associated deaths will occur. To reach the WHO HCV elimination targets by 2030, 880 000 annual DAA treatments are required if prevention is not scaled up and no treatment prioritization occurs. By targeting treatment toward persons with cirrhosis (80{\%} treated annually) and PWIDs (double the treatment rate of non-PWIDs), the required annual treatment number decreases to 750 000. If prevention activities also halve transmission risk, this treatment number reduces to 525 000 annually.ConclusionsSubstantial HCV prevention and treatment interventions are required to reach the WHO HCV elimination targets in Pakistan, without which Pakistan’s HCV burden will increase markedly.",
author = "Lim, {Aaron G} and Huma Qureshi and Hassan Mahmood and Saeed Hamid and Davies, {Charlotte F} and Adam Trickey and Nancy Glass and Quaid Saeed and Hannah Fraser and Walker, {Josephine G} and Christinah Mukandavire and Matthew Hickman and Martin, {Natasha K} and May, {Margaret T} and Francisco Averhoff and Peter Vickerman",
year = "2018",
month = "1",
day = "3",
doi = "10.1093/ije/dyx270",
language = "English",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Curbing the Hepatitis C virus epidemic in Pakistan

T2 - the impact of scaling up treatment and prevention for achieving elimination

AU - Lim, Aaron G

AU - Qureshi, Huma

AU - Mahmood, Hassan

AU - Hamid, Saeed

AU - Davies, Charlotte F

AU - Trickey, Adam

AU - Glass, Nancy

AU - Saeed, Quaid

AU - Fraser, Hannah

AU - Walker, Josephine G

AU - Mukandavire, Christinah

AU - Hickman, Matthew

AU - Martin, Natasha K

AU - May, Margaret T

AU - Averhoff, Francisco

AU - Vickerman, Peter

PY - 2018/1/3

Y1 - 2018/1/3

N2 - BackgroundThe World Health Organization (WHO) has developed a global health strategy to eliminate viral hepatitis. We project the treatment and prevention requirements to achieve the WHO HCV elimination target of reducing HCV incidence by 80% and HCV-related mortality by 65% by 2030 in Pakistan, which has the second largest HCV burden worldwide.MethodsWe developed an HCV transmission model for Pakistan, and calibrated it to epidemiological data from a national survey (2007), surveys among people who inject drugs (PWID), and blood donor data. Current treatment coverage data came from expert opinion and published reports. The model projected the HCV burden, including incidence, prevalence and deaths through 2030, and estimated the impact of varying prevention and direct-acting antiviral (DAA) treatment interventions necessary for achieving the WHO HCV elimination targets.ResultsWith no further treatment (currently ∼150 000 treated annually) during 2016–30, chronic HCV prevalence will increase from 3.9% to 5.1%, estimated annual incident infections will increase from 700 000 to 1 100 000, and 1 400 000 HCV-associated deaths will occur. To reach the WHO HCV elimination targets by 2030, 880 000 annual DAA treatments are required if prevention is not scaled up and no treatment prioritization occurs. By targeting treatment toward persons with cirrhosis (80% treated annually) and PWIDs (double the treatment rate of non-PWIDs), the required annual treatment number decreases to 750 000. If prevention activities also halve transmission risk, this treatment number reduces to 525 000 annually.ConclusionsSubstantial HCV prevention and treatment interventions are required to reach the WHO HCV elimination targets in Pakistan, without which Pakistan’s HCV burden will increase markedly.

AB - BackgroundThe World Health Organization (WHO) has developed a global health strategy to eliminate viral hepatitis. We project the treatment and prevention requirements to achieve the WHO HCV elimination target of reducing HCV incidence by 80% and HCV-related mortality by 65% by 2030 in Pakistan, which has the second largest HCV burden worldwide.MethodsWe developed an HCV transmission model for Pakistan, and calibrated it to epidemiological data from a national survey (2007), surveys among people who inject drugs (PWID), and blood donor data. Current treatment coverage data came from expert opinion and published reports. The model projected the HCV burden, including incidence, prevalence and deaths through 2030, and estimated the impact of varying prevention and direct-acting antiviral (DAA) treatment interventions necessary for achieving the WHO HCV elimination targets.ResultsWith no further treatment (currently ∼150 000 treated annually) during 2016–30, chronic HCV prevalence will increase from 3.9% to 5.1%, estimated annual incident infections will increase from 700 000 to 1 100 000, and 1 400 000 HCV-associated deaths will occur. To reach the WHO HCV elimination targets by 2030, 880 000 annual DAA treatments are required if prevention is not scaled up and no treatment prioritization occurs. By targeting treatment toward persons with cirrhosis (80% treated annually) and PWIDs (double the treatment rate of non-PWIDs), the required annual treatment number decreases to 750 000. If prevention activities also halve transmission risk, this treatment number reduces to 525 000 annually.ConclusionsSubstantial HCV prevention and treatment interventions are required to reach the WHO HCV elimination targets in Pakistan, without which Pakistan’s HCV burden will increase markedly.

U2 - 10.1093/ije/dyx270

DO - 10.1093/ije/dyx270

M3 - Article

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

M1 - dyx270

ER -