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Title: Achieving WHO recommendations for Hepatitis C Virus Elimination in Belgium
Authors: Bourgeois, Stefan
Blach, Sarah
Brixko, Christian
Laleman, Wim
Mathei, Catharina
Mulkay, Jean-Pierre
Razavi, Homie
Starkel, Peter
Van Damme, Pierre
Van Vlierberghe, Hans
VANDIJCK, Dominique 
Moreno, Christophe
Issue Date: 2016
Abstract: Background : The World Health Organization (WHO) released updated guidelines for the screening, care and treatment of patients with chronic hepatitis C virus (HCV) infection. Methods : A previously described HCV disease burden model was used to develop a "WHO scenario" to achieve the WHO recommendations of a 90% reduction in incidence and 65% reduction in liver-related deaths. After determining the steps necessary to achieve this goal, the impact of realistic constraints was modeled. Results : In 2015, there were 66.200 viremic infections, with 43% diagnosed and 1.350 treated. In order to reduce new infections, treatment must be extended to >= F0 patients, including people who inject drugs and other individuals at risk of transmitting HCV. Additionally, diagnosis and treatment of 3.030 and 4.060 patients, respectively, would be required. The largest attenuation of the WHO scenario would occur if no new cases were diagnosed after 2018 (300% more viremic infections by 2030). Limiting treatment to >= F2 patients or treating fewer patients (3.000) would result in 220% or 140% more viremic cases, respectively, compared with the WHO scenario. Conclusions : Achieving the WHO guidelines in Belgium requires a coordinated effort to scale up treatment and prevention efforts and to allow treatment access to patients of all fibrosis stages. A scale-up of treatment, however, requires patients to be both diagnosed and linked to care, suggesting a need for increased awareness and expanded screening efforts. Finally, prevention of new HCV infections requires a comprehensive understanding of the population at risk of transmitting HCV.
Notes: [Bourgeois, Stefan] ZNA Campus Stuivenberg, Antwerp, Belgium. [Blach, Sarah; Razavi, Homie] Ctr Dis Anal, Louisville, CO USA. [Brixko, Christian] CHR Citadelle, Dept Gastroenterol & Digest Oncol, Liege, Belgium. [Laleman, Wim] Katholieke Univ Leuven, Univ Hosp Leuven, Leuven, Belgium. [Mathei, Catharina] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Univ Hosp Leuven, Leuven, Belgium. [Mulkay, Jean-Pierre] CHU St Pierre, Hepatogastroenterol, Brussels, Belgium. [Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium. [Robaeys, Geert] Hasselt Univ, Fac Med & Life Sci, Diepenbeek, Belgium. [Robaeys, Geert] UZ Leuven, Dept Hepatol, Leuven, Belgium. [Starkel, Peter] Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium. [Van Damme, Pierre] Univ Antwerp, Antwerp, Belgium. [Van Vlierberghe, Hans] Ghent Univ Hosp, Ghent, Belgium. [Vandijck, Dominique] Univ Ghent, Ghent, Belgium. [Vandijck, Dominique] Hasselt Univ, Dept Hlth Econ & Patient Safety, Diepenbeek, Belgium. [Moreno, Christophe] Univ Libre Bruxelles, CUB Hop Erasme, Brussels, Belgium.
Keywords: hepatitis C virus; treatment; screening; elimination;hepatitis C virus; treatment; screening; elimination
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ISSN: 0001-5644
ISI #: 000384746300009
Rights: © Acta Gastro-Enterologica Belgica.
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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