Strategies to eliminate hepatitis C in Croatia, a modelling study

Scientific paper - Original scientific paper

• Title (croatian): Strategije za eliminaciju hepatitisa C u Hrvatskoj, studija modeliranja
• Author: Adriana Vince
• Author: Ellen Dugan
• Author: Tatjana Nemeth-Blažić
• Author: Tajana Filipec
• Author: Irena Hrstić
• Author: Boris Lukšić
• Author: Diana Nonković
• Author: Tatjana Reic
• Author: Samantha Coleman
• Author: Homie Razavi
• Author: Sarah Blach
• Author's institution: University of Zagreb; School of Medicine; (Department of Infectious Diseases)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract (english)

Background: Since a 2016 analysis on the epidemiology and disease burden of HCV in Croatia, the HCV treatment paradigm has shifted substantially. Fibrosis restrictions were removed, and the number of patients treated tripled. With these encouraging changes to policy and practice, an updated analysis was completed to guide resource allocation and a national strategic plan for HCV elimination in Croatia. ----- Methods: A comprehensive literature review and discussions with in-country experts were used to identify epidemiological factors defining HCV disease burden in Croatia. An HCV disease burden model, seeded with this data, was used to assess the impact of increasing screening rates and delineate the steps needed to reach the World Health Organization’s (WHO) Global Health and Sector Strategy hepatitis C elimination targets. ----- Results: Achieving WHO elimination targets would reduce the number of viremic cases of HCV from 21,000 in 2015 to 4,000 by 2030 while averting 500 liver-related deaths, and 680 cases of hepatocellular carcinoma and decompensated cirrhosis from 2015 to 2030, relative to the projections under the current standard of care. Screening practices will need to ramp up to testing about 250,000 Croatians annually so that about 1,500 patients can be diagnosed and treated each year. ----- Conclusions: Elimination requires a coordinated effort between country and industry leaders including government authorities, policymakers and healthcare and insurance providers. Improved screening mechanisms will be needed for the scale-up required to achieve goals.

Abstract (croatian)

Uvod: Nakon posljednje analize epidemioloških i kliničkih podataka o HCV infekciji iz 2016. godine došlo je do velikih promjena u paradigmi liječenja. Uklonjene su restrikcije vezane uz uznapredovali stadij fibroze jetre, a broj liječenih se utrostručio. S obzirom na ohrabrujuće činjenice u mogućnostima liječenja napravljena je nova analiza, koja će peciznije usmjeriti prioritete i alokaciju resursa za provedbu nacionalnog akcijskog plana za eliminaciju hepatitisa C.----- Metode: Opsežan pregled literature i razgovori s hrvatskim stručnjacima korišteni su za identificiranje epidemioloških čimbenika koji definiraju opterećenje bolešću uzrokovanom virusom hepatitisa C u Hrvatskoj. Dobiveni podatci korišteni su u postojećem matematičkom modelu za procjenu opterećenja bolešću uzrokovanom HCV-om (engl. HCV disease burden model), kako bi se procijenio učinak povećanih stopa probira (engl. screening) i zacrtao putokaz potrebnih koraka za dostizanje globalnih ciljeva Strategije Svjetske zdravstvene organizacije (SZO) za eliminaciju hepatitisa C. ----- Rezultati: Postizanje ciljeva SZO-a značilo bi redukciju HCV viremičnih slučajeva na 4.000 u 2030. uz sprječavanje 500 smrtnih ishoda uzrokovanih bolestima jetre i 680 slučajeva hepatocelularnog karcinoma i dekompenzirane ciroze u razdoblju od 2015. do 2030., za koje se procjenjuje da bi nastali uz sadašnju razinu probira i kliničku praksu. Prema upotrijebljenom matematičkom modelu to bi zahtijevalo povećanje broja testiranja na 250.000 osoba godišnje, kako bi se godišnje dijagnosticiralo i liječilo 1.500 pacijenata. ----- Zaključak: Eliminacija virusnih hepatitisa kompleksan je proces koji zahtijeva koordinirane aktivnosti i suradnju između medicinskih stručnjaka, državne politike, donositelja odluka i pružatelja zdravstvenog osiguranja. Povećanje opsega probirnog testiranja bit će ključno za postizanje ciljeva SZO-a u Hrvatskoj.

• Keywords (english): HEPATITIS C – diagnosis, epidemiology, prevention and control; NATIONAL HEALTH PROGRAMS – trends; CROATIA – epidemiology; WORLD HEALTH ORGANIZATION; MODELS, THEORETICAL
• Language: english
• Language: croatian
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 142, no. 9-10, pp. 285-295
• p-ISSN: 0024-3477
• e-ISSN: 1849-2177
• DOI: https://doi.org/10.26800/LV-142-9-10-44
• URN:NBN: urn:nbn:hr:105:344412
• Publication: 2020
• Document URL: https://hrcak.srce.hr/245799
• Type of resource: Text
• Access conditions: Open access
• Created on: 2021-04-21 11:24:37