Number of people treated for hepatitis C virus infection in 2014-2023 and applicable lessons for new HBV and HDV therapies.
Journal: Journal of hepatology
Volume:
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Affiliated Institutions: Center for Disease Analysis Foundation, Lafayette, United States. Electronic address: hrazavi@cdafound.org. Hepatology, National Liver Institute, Shebeen El Kom, Egypt. Gastroenterologist, Focal Point Hepatitis, Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan. National Center for Global Health, Istituto Superiore di Sanita, Rome, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy. Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. Epidemiology, Infectious Disease Control and Prevention, Hiroshima University, Hiroshima, Japan. CUNY Graduate School of Public Health and Health Policy, New York City, United States; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. Global Hepatitis Programme, World Health Organization, Geneva, Switzerland. Hepatogastroenterology, Dr. Ziauddin University Hospital, Karachi, Pakistan. Internal Medicine - Gastroenterology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Department of Gastroenterology, Humanitas Research Hospital IRCCS, Rozzano, Italy. Infectious Diseases, Helsinki University Hospital, Helsinki, Finland. Department of Gastroenterology, Ege University, Medical School, Izmir, Turkey. Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, AlKhoudh, Oman. Department of Medicine, King Saud University, Riyadh, Saudi Arabia. Internal Medicine, Division of Gastroenterology and Hepatology, Armed Forces Hospital, Muscat, Oman. World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. Viral Hepatitis Control Program, Ministry of Health, Ryiadh, Saudi Arabia. Gastroenterology Unit, Department of Medicine, King Fahad Military Medical Complex, Dhahran, Saudi Arabia. PAHO/WHO, Washington DC, United States. Public Health, MOH, Riyadh, Saudi Arabia. Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India. Hepatology Department, Université de Paris-Cité, Hôpital Beaujon, AP-HP, INSERM UMR, Paris, France. Public Health Department, Ministry of Health, Riyadh, Saudi Arabia. Department of Public Health Policy, University of West Attica, Athens, Greece. Ministry of Health, Kampala, Uganda. Liver Medicine Center of Excellence, Assuta medical Centers, Tel Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany. Internal Medicine & Gastroenterology, University of Rio de Janeiro, Rio de Janeiro, Brazil; Clinica de Doenças do Fígado, Rio de Janeiro, Brazil. Department of Hepatology, Imperial College Healthcare NHS Trust, London, United Kingdom. Department of Medicine, Henry Ford Hospital, Detroit, United States. Medicine, Weill Cornell Medicine, New York, United States. Arud Centre for Addiction Medicine, Zürich, Switzerland. Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Hepatology Unit, University Hospital of Pisa, Pisa, Italy. Liver Unit, Hospital Universitari Vall d Hebron and CIBEREHD del Insituto Carlos III. Universidad Autonoma de Barcelona, Barcelona, Spain. Department of Gastroenterology and Hepatology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. National Medical Research Center of Phthisiopulmonology & Infectious Diseases, Moscow, Russia; Department of Infectious Diseases, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia. Department of Hepatology, Hospital Christus Muguerza Alta Especialidad, Monterrey, Mexico. Medicine / Microbiology and Infectious Diseases Department, Cumming School of Medicine, University of Calgary, Calgary, Canada. Mental health and Public medicine, University of Campania, Naples, Italy. PROMISE, School of Medicine, University of Palermo, Palermo, Italy. Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain; School of Medicine, University of Cantabria, Santander, Spain. School of Public Health, Peking University, Beijing, China's Mainland. Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway. Mexico. Service d'hepatologie et de transplantation hepatique, CHU, Bordeaux, France. Institute for Liver Medicine, Icahn School of Medicine at Mount Sinai, New York, United States. nd Dept of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Kosice, Slovakia. Centre des Maladies Digestives, Lausanne, Switzerland. Endemic Medicine Department, Helwan University, Cairo, Egypt. Gastroenterology Department, Hamad Medical Corporation, Doha, Qatar. Endemic medicine department, Cairo University Hospitals, Cairo, Egypt. Department of Hepatology, Hospital Universitario Vall d'Hebron, Barcelona, Spain. Center for Disease Analysis Foundation, Lafayette, United States. Global Hepatitis Programme, WHO, Geneva, Switzerland. Division of Infectious Disease, Federal University of São Paulo, São Paulo, Brazil. Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland. Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czechia. Infectious Diseases, University Vanvitelli, Napoli, Italy. New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand. Gastroenterology Professor at Universidad Autonoma de Santo Domingo / Doctor at Centro Endoscopico Digestivo Integral / Retire doctor from the Health Ministry in the Dominican Republic, Santo Domingo, Dominican Republic. Liver Unit, Hospital Universitario La Paz, CIBERehd/IdiPAZ. Universidad Autónoma de Madrid, Madrid, Spain. Department of Gastroenterology and Hepatology, Yerevan State Medical University, Yerevan, Armenia. Departments of science and infectious diseases, Landspitali University Hospital, Reykjavík, Iceland; Faculty of Medicine, University of Iceland, Reykjavík, Iceland. Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria; Sigmund Freud University, Vienna, Austria. Department of HIV/Aids, Tuberculosis, Viral Hepatitis and Sexually Transmitted Infections, Ministry of Health, Brasilia, Brazil. The Kirby Institute, UNSW, Sydney, Australia. Medicine, Aga Khan University, Karachi, Pakistan. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Liver Unit, Centre hospitalier de l'Universite de Montreal, Montreal, Canada. Department of Infectology and Travel Medicine, P.J. Safarik University, Faculty of Medicine and L. Pasteur University Hospital, Kosice, Slovakia. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Division of Gastroenterology, First Department of Medicine, Clinical Centre, University of Pecs, Budapest, Hungary. School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom; Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, United Kingdom. Division of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines. Department of Infectious Diseases and Emergency Infectious Disease, Division of Highly Contagious Infections Diseases, "D. Cotugno" hospital, Naples, Italy. Riga East University hospital, Riga, Latvia; Faculty of Medicine, Riga Stradins University, Riga, Latvia. Vestfold Hospital Trust, Tonsberg, Norway. National Research Oncology Center, Astana, Kazakhstan. Hepatitis Research Center , National Taiwan University Hospital, Taipei, Taiwan. Research Center for Substance Use Disorders and Mental Illness, Innlandet Hospital Trust, Brumunddal, Norway. Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou, Benin. Institute of Human Virology, University of Maryland School of Medicine, Baltimore, United States. Medicine, Stanford University School of Medicine, Redwood City, United States. Department of Infectious Diseases / Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden. Institute of Health Policy and Development Studies, University of the Philippines, Manila, Philippines. Independent Health Services Researcher, Madrid, Spain. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Liver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, CIBERehd, Barcelona, Spain. Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania; Department of Chemistry and Bioengineering, VILNIUS TECH, Faculty of Fundamental Sciences, Vilnius, Lithuania. Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of. Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary. Dept. of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. HIV/Aids, Tuberculosis and Hepatitis, WHO, Ouagadougou, Burkina Faso. Gastroenterology, Asian Institute of Medical Sciences (AIMS), Hyderabad, Pakistan. Department of Infectious Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Br, Sao Paulo, Brazil. Department of Infectious Diseases and Viral Hepatitis, Azienda Ospedaliera Sant'Anna e San Sebastiano di Caserta, Caserta, Italy. Department of Gastroenterology, Oslo University Hospital, Oslo, Norway. HSE, Health Protection Surveillance Centre, Dublin, Ireland. Virology, Research Institute of Virology, Tashkent, Uzbekistan. Communicable Diseases, Environment and Health, World Health Organization Regional Office for Europe, Copenhagen, Denmark. Medicine, University of Geneva, Geneva, Switzerland. CD team, WHO, Phnom Penh, Cambodia. Internal Medicine, Makerere University, Kampala, Uganda. Department of Gastroenterology and Hepatology, Landspitali - National University Hospital of Iceland, Reykjavik, Iceland. Department of Medicine, University of Benin, Benin City, Nigeria. Hospital Santa Caterina, Salt, Girona, Spain. Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, United States. First Department of Gastroenterology, Medical School, National and Kapodistrian University of Athens, Athens, Greece. National Medical Research Center of Phthisiopulmonology & Infectious Diseases, Moscow, Russia; Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Center for Global Health, Istituto Superiore di Sanità, Rome, Italy. Department of Medicine, University of British Columbia, Vancouver, Canada. Specialist in Gastroenterology and Internal Medicine, Helsinki University Hospital Abdominal Center, Helsinki, Finland. Hepatology Section, Department of Medicine., Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno "CEMIC"., Ciudad Autónoma de Buenos Aires, Argentina. Dirección de Promoción y Prevención, Ministerio de Salud y Protección Social, Bogotá, Colombia. The Research institute of Virology of the Republican specialized scientific practical medical center of epidemiology, microbiology, infections and parasitics diseases, Tashkent, Uzbekistan. Gastroenterology, King Abdulaziz Medical City, Jeddah, Saudi Arabia. Medizinische Klinik , St. Josefs-Hospital, Wiesbaden, Germany; Medizinische Klinik , Goethe-University, Frankfurt am Main, Germany. Department of Science and International Cooperation, Kazakh Science Center of Dermatology and Infectious Diseases, Almaty, Kazakhstan. Department of Infectology and Travel Medicine, Medical Faculty, PJ Safárik University, Kosice, Slovakia. Department of Infection and Immunity, Luxembourg Institute of Health, Esch sur Alzette, Luxembourg. Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Egyptian Liver Research Institute and Hospital, , Mansoura, Egypt. Communicable Disease Surveillance Centre, Health Protection, Public Health Wales, Cardiff, United Kingdom. Gastroenterology and Hepatology, Port Said University, Port Said, Egypt and Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt. Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria. Department of Medicine, University of OtagoChristchurch, New Zealand; Gastroenterology, Christchurch Hospital, Christchurch, New Zealand. Department of Hepatology & Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany. Keck Medicine of University of Southern California, Los Angeles, United States. Hepatology Department, Riga East University Hospital, Latvian Center of Infectious Diseases, Riga, Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia. Internal Medicine & Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands. NUST School of Health Sciences, National University of Sciences and Technology (NUST), H-, Islamabad, Pakistan; Advanced Research Centre, European University of Lefke, Lefke, Northern Cyprus, TR- Mersin, Turkey. Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway. Medical Data Analytics Centre (MDAC), Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden. Gastroenterology and hepatology, NROC, Astana, Kazakhstan; Department of medicine III, RWTH University hospital Aachen, Aachen, Germany. School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Goethe-University, Department of Medicine, University Hospital, Frankfurt, Germany. Liver Unit, Carmel Medical Center, Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
Abstract summary
The year 2023 marked the 10-year anniversary of the launch of direct-acting antivirals (DAAs) for the treatment of the hepatitis C virus (HCV). HCV treatment trends by country, region, and globally are important to monitor progress toward the World Health Organization's 2030 elimination targets. Additionally, the historical patterns can help predict the treatment uptake for future therapies for other liver diseases.The number of people living with HCV (PLHCV) treated between 2014-2023 across 119 countries was estimated using national HCV registries, reported DAA sales data, pharmaceutical companies' reports, and estimates provided by national experts. For the countries with no available data, the average estimate of the corresponding Global Burden of Disease region was used.An estimated 13,816,000 (95% uncertainty intervals (UI): 13,221,000-16,415,000) PLHCV were treated, of whom 12,748,000 (12,226,000-15,231,000) were treated with DAAs, of which 11,081,000 (10,542,000-13,338,000) were sofosbuvir-based DAA regimens. Country-level data accounted for 97% of these estimates. In high-income countries, there was a 41% drop in treatment from its peak, and reimbursement was a large predictor of treatment. In low- and middle-income countries, price played an important role in expanding treatment access through the public and private markets, and treatment continues to increase slowly after a sharp drop at the end of the Egyptian national program.In the last 10 years, 21% of all HCV infections were treated with DAAs. Regional and temporal variations highlight the importance of active screening strategies. Without program enhancements, the number of treated PLHCV stalled in every country/region which may not reflect a lower prevalence but may instead reflect the diminishing returns of the existing strategies.Long-term hepatitis C virus (HCV) infection can lead to cirrhosis and liver cancer. Since 2014, these infections can be effectively treated with 8-12 weeks of oral therapies. In 2015, the World Health Organization (WHO) established targets to eliminate HCV by 2030, which included treatment targets for member countries. The current study examines HCV treatment patterns across 119 countries and regions from 2014 to 2023 to assess the impact of national programs. This study can assist physicians and policymakers in understanding treatment patterns within similar regions or income groups and in utilizing historical data to refine their strategies in the future.Authors & Co-authors: Razavi Homie A HA Waked Imam I Qureshi Huma H Kondili Loreta A LA Duberg Ann-Sofi AS Aleman Soo S Tanaka Junko J Lazarus Jeffrey V JV Low-Beer Daniel D Abbas Zaigham Z Rached Antoine Abou AA Aghemo Alessio A Aho Inka I Akarca Ulus S US Al-Busafi Said A SA Al-Hamoudi Waleed K WK Al-Naamani Khalid K Alaama Ahmed Sabry AS Aldar Manahil M MM Alghamdi Mohammed M Gonzalez Monica Alonso MA Alserehi Haleema H Anand Anil C AC Asselah Tarik T Assiri Abdullah M AM Athanasakis Kostas K Atugonza Rita R Ben-Ari Ziv Z Berg Thomas T Brandão-Mello Carlos E CE Brown Ashley S M ASM Brown Kimberly A KA Brown Robert S RS Bruggmann Philip P Brunetto Maurizia R MR Buti Maria M Cheinquer Hugo H Christensen Peer Brehm PB Chulanov Vladimir V Cisneros Garza Laura E LE Coffin Carla S CS Coppola Nicola N Craxi Antonio A Crespo Javier J Cui Fuqiang F Dalgard Olav O De La Torre Alethse A De Ledinghen Victor V Dieterich Douglas D Drazilova Sylvia S Dufour Jean-François JF El-Kassas Mohamed M Elbadri Mohammed M Esmat Gamal G Mur Rafael Esteban RE Eurich Brandon B Faini Diana D Ferreira Paulo R A PRA Flisiak Robert R Frankova Sona S Gaeta Giovanni B GB Gamkrelidze Ivane I Gane Edward J EJ Garcia Virginia V García-Samaniego Javier J Gemilyan Manik M Gottfredsson Magnus M Gschwantler Michael M Gurski Ana P M APM Hajarizadeh Behzad B Hamid Saeed S SS Hatzakis Angelos A Hercun Julian J Hockicková Ivana I Huang Jee-Fu JF Hunyady Bela B Hutchinson Sharon J SJ Ishikawa Naoko N Izumi Kiyohiko K Izzi Antonio A Janicko Martin M Jarcuska Peter P Jeruma Agita A Johannessen Asgeir A Kaliaskarova Kulpash S KS Kao Jia-Horng JH Kielland Knut B KB Kodjoh Nicolas N Kottilil Shyamasundaran S Kristian Pavol P Kwo Paul Y PY Lagging Martin M Lam Hilton H Lázaro Pablo P Lee Mei-Hsuan MH Lens Sabela S Liakina Valentina V Lim Young-Suk YS Makara Michael M Manns Michael M Manzengo Casimir Mingiedi CM Memon Sadik S Mendes-Correa Maria Cássia MC Messina Vincenzo V Midgard Håvard H Murphy Niamh N Musabaev Erkin E Naveira Marcelo C M MCM Nde Helen H Negro Francesco F Nim Nirada N Ocama Ponsiano P Olafsson Sigurdur S Omuemu Casimir E CE Pamplona Javier J JJ Pan Calvin Q CQ Papatheodoridis George V GV Pimenov Nikolay N Poustchi Hossein H Quaranta Maria Giovanna MG Ramji Alnoor A Rautiainen Henna H Razavi-Shearer Devin M DM Razavi-Shearer Kathryn K Ridruejo Ezequiel E Ríos-Hincapié Cielo Y CY Sadirova Shakhlo S Sanai Faisal M FM Sarrazin Christoph C Sarybayeva Gulya G Schréter Ivan I Seguin-Devaux Carole C Sereno Leandro S LS Shiha Gamal G Smith Josie J Soliman Riham R Sonderup Mark W MW Spearman C Wendy CW Stauber Rudolf E RE Stedman Catherine A M CAM Sypsa Vana V Tacke Frank F Terrault Norah A NA Tolmane Ieva I Van Welzen Berend B Voeller Alexis S AS Waheed Yasir Y Wallace Carolyn C Whittaker Robert N RN W-S Wong Vincent V Ydreborg Magdalena M Yesmembetov Kakharman K Yu Ming-Lung ML Zeuzem Stefan S Zuckerman Eli E
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Doi : S0168-8278(25)00020-0SSN : 1600-0641