A micro-elimination approach to addressing hepatitis C in Turkey

Area of Science:

• Hepatology and Viral Hepatitis Research
• Public Health Policy and Strategy
• Epidemiology and Disease Modeling

Background:

• Turkey's commitment to the WHO Global Health Sector Strategy (GHSS) for viral hepatitis elimination by 2030.
• The study addresses the need for updated national prevalence data and elimination modeling for Hepatitis C Virus (HCV).

Purpose of the Study:

• To report new national prevalence data for HCV in Turkey, disaggregated by subpopulation.
• To model different scenarios for achieving HCV elimination targets by 2030.
• To evaluate the impact of increased treatment and direct-acting antiviral (DAA) access on HCV burden.

Main Methods:

• Literature review for existing HCV disease burden estimates in Turkey.
• Development of a disease burden model incorporating stakeholder input and sequelae.
• Scenario modeling: Base 2017 (standard care), Increased Treatment (improved DAA access), and WHO Targets (65% mortality reduction, 90% diagnosis rate).

Main Results:

• Estimated 271,000 viremic HCV infections in early 2017, with 58,400 diagnosed and 10,200 treated.
• Current treatment trends project a 35% decline in viremic infections by 2030, with 10-25% reduction in liver mortality and sequelae.
• Increased treatment and WHO targets scenarios project 50-80% reduction in viremic infections and 45-85% reduction in liver disease complications by 2030.

Conclusions:

• Significant increase in HCV treatment rates is necessary for Turkey to achieve WHO elimination targets.
• Improved access to direct-acting antivirals (DAAs) nationwide is essential.
• Further data collection on disease burden within specific subpopulations is required for micro-elimination efforts.