Disease burden of chronic hepatitis C in Brazil

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis C virus (HCV) infection is a significant global health concern.
• It is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation worldwide.
• Understanding disease progression and burden is vital for effective public health interventions.

Purpose of the Study:

• To estimate the progression of Hepatitis C virus disease in Brazil.
• To quantify the burden of HCV infection on a national scale.
• To compare the impact of different intervention strategies on disease outcomes.

Main Methods:

• A mathematical model was utilized to forecast HCV disease progression and case numbers at various stages.
• The model quantified the HCV-infected population and disease progression in Brazil.
• Two intervention strategies were compared: one focusing on higher sustained virological response (SVR) and treatment eligibility, the other on increased diagnosis and treatment rates with higher SVR.

Main Results:

• The number of individuals infected with HCV is projected to decline by 35% by 2030.
• Cases of compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and liver-related deaths are expected to peak between 2028 and 2032.
• Strategy 2, emphasizing increased diagnosis and treatment, led to a tenfold increase in treated cases by 2020, a 90% reduction in infected individuals by 2030, and significant decreases in liver-related deaths (70%), liver cancer (75%), and decompensated cirrhosis (80%).

Conclusions:

• Despite declining HCV incidence and prevalence in Brazil, advanced liver disease cases are increasing.
• Higher sustained virological response rates are important, but new strategies must prioritize increasing patient diagnosis and treatment eligibility.
• Implementing these enhanced strategies is essential to effectively reduce the overall burden of Hepatitis C virus infection in Brazil.