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Hepatitis C: global epidemiology and strategies for control
S Lanini1, P J Easterbrook2, A Zumla3
1'Lazzaro Spallanzani' National Institute for Infectious Diseases-IRCCS, Rome, Italy.
Insights
Hepatitis C (HCV) affects 100 million globally, causing 700,000 deaths annually. New direct-acting antiviral drugs offer a cure, enabling potential global elimination of this public health threat.
Area of Science:
- Hepatology
- Epidemiology
- Public Health
Background:
- Hepatitis C virus (HCV) infection impacts approximately 100 million individuals worldwide, leading to an estimated 700,000 deaths annually.
- Prevalence is highest in lower and middle-income countries, often linked to iatrogenic transmission and unsafe injection practices, while developed nations see infections primarily in high-risk populations like people who inject drugs.
Purpose of the Study:
- To review the global epidemiology of Hepatitis C virus (HCV).
- To explore opportunities for preventative and treatment interventions to achieve global control of HCV infection.
- To summarize key elements of the World Health Organization's global health sector strategy for viral hepatitis.
Main Methods:
- Literature review of global HCV epidemiology.
- Analysis of current treatment modalities, focusing on direct-acting antivirals (DAAs).
- Examination of public health strategies for HCV control and elimination.
Main Results:
- Chronic hepatitis C is now a curable condition due to highly effective, well-tolerated direct-acting antiviral (DAA) oral drugs.
- DAAs demonstrate extraordinary clinical performance, with recent price reductions and expanded access in resource-limited settings.
- These advancements provide a significant opportunity for the control and elimination of hepatitis C as a public health threat.
Conclusions:
- Hepatitis C can be effectively treated and potentially eliminated as a public health concern.
- Global collaboration and implementation of strategies like the WHO's are crucial for HCV control.
- Increased access to affordable DAAs is vital for achieving global HCV elimination goals.
Abstract:
It is estimated that globally there are approximately 100 million persons with serological evidence of current or past HCV infection, and that HCV causes about 700 000 deaths each year. The prevalence of infection is the highest in lower and middle income countries, in which a significant number of past infections were caused by iatrogenic transmission and sub-optimal injection safety. In contrast, in developed countries, infections are caused mainly by high-risk exposures and behaviours among specific populations, such as persons who inject drugs. Recently, new direct antiviral activity (DAA) oral drugs with high rates of cure over short duration, which are well tolerated, have made chronic hepatitis C a curable condition. The extraordinary clinical performance of DAAs and recent substantial price reductions and expansion in access in resource-limited settings has provided new impetus for potential control and elimination of hepatitis C as a public health threat. We review the global epidemiology of HCV and the opportunities for preventative and treatment interventions to achieve global control of HCV infection. We also summarize the key elements of the World Health Organization's first-ever global health sector strategy for addressing the viral hepatitis pandemic.
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