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Progress toward implementing the Swiss Hepatitis Strategy: Is HCV elimination possible by 2030?
Beat Müllhaupt1, Philip Bruggmann2, Florian Bihl3
1Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland.
Plos One
|January 1, 2019
Summary
Updated analysis shows Hepatitis C virus (HCV) infections in Switzerland are declining. Continued diagnosis and treatment are crucial for HCV elimination by 2030, preventing increased liver disease and deaths.
Area of Science:
- Epidemiology
- Public Health
- Hepatology
Background:
- The Swiss Hepatitis Strategy aims to eliminate viral hepatitis by 2030.
- Previous burden of disease estimates for Hepatitis C virus (HCV) in Switzerland require updating due to new prevalence data.
- New data indicates a significant decrease in total HCV infections.
Purpose of the Study:
- To provide an updated estimate of viremic HCV prevalence in Switzerland.
- To evaluate the impact of 'inaction' and intervention scenarios on liver-related morbidity and mortality by 2030.
- To assess progress towards the Global Health Sector Strategy and Swiss Hepatitis Strategy goals.
Main Methods:
- Utilized a Markov disease-progression model.
- Calculated present and future burden of HCV infection by disease stage.
- Incorporated updated prevalence data from the Swiss Federal Office of Public Health.
Main Results:
- In 2017, an estimated 36,800 viremic HCV infections were present in Switzerland.
- Under current care, viremic infections are projected to decrease by 45%, with a 20% reduction in cirrhosis, cancer, and liver deaths.
- Halting treatment and diagnosis by 2018 would increase late-stage HCV morbidity and mortality by 90-100% by 2030.
Conclusions:
- Despite a declining HCV epidemic in Switzerland, intensified diagnosis and treatment efforts are essential.
- Achieving the Global Health Sector Strategy or Swiss Hepatitis Strategy goals can reduce chronic infections to under 13,000 or 4,000, respectively.
- Sustained and expanded interventions are necessary to meet the 2030 HCV elimination targets.
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