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Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections

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journal contribution
submitted on 2024-05-27, 11:20 and posted on 2024-05-27, 11:20 authored by Houssein H Ayoub, Laith J Abu-Raddad

Objective

Direct-acting antivirals have opened an opportunity for controlling hepatitis C virus (HCV) infection in Pakistan, where 10% of the global infection burden is found. We aimed to evaluate the implications of five treatment programme scenarios for HCV treatment as prevention (HCV-TasP) in Pakistan.

Design

An age-structured mathematical model was used to evaluate programme impact using epidemiological and programme indicators.

Setting

Total Pakistan population.

Participants

Total Pakistan HCV-infected population.

Interventions

HCV treatment programme scenarios from 2018 up to 2030.

Results

By 2030 across the five HCV-TasP scenarios, 0.6–7.3 million treatments were administered, treatment coverage reached between 3.7% and 98.7%, prevalence of chronic infection reached 2.4%–0.03%, incidence reduction ranged between 41% and 99%, program-attributed reduction in incidence rate ranged between 7.2% and 98.5% and number of averted infections ranged between 126 221 and 750 547. Annual incidence rate reduction in the first decade of the programme was around 6%–18%. Number of treatments needed to prevent one new infection ranged between 4.7–9.8, at a drug cost of about US$900. Cost of the programme by 2030, in the most ambitious elimination scenario, reached US$708 million. Stipulated WHO target for 2030 cannot be accomplished without scaling up treatment to 490 000 per year, and maintaining it for a decade.

Conclusion

HCV-TasP is a highly impactful and potent approach to control Pakistan’s HCV epidemic and achieve elimination by 2030.

Other Information

Published in: BMJ Open
License: https://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1136/bmjopen-2018-026600

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

BMJ

Publication Year

  • 2019

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License

Institution affiliated with

  • Qatar University
  • College of Arts and Sciences - QU
  • Weill Cornell Medicine - Qatar
  • Hamad Bin Khalifa University
  • College of Health and Life Sciences - HBKU