Planning the hepatitis C virus elimination in Cyprus: A modeling study.

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis C virus (HCV) infection presents a significant global health challenge.
• In Cyprus, chronic hepatitis C (CHC) prevalence is 0.6% in the general population and 46% among people who inject drugs (PWID).
• Direct-acting antivirals (DAAs) for HCV elimination are not yet widely accessible in Cyprus, necessitating strategic planning.

Purpose of the Study:

• To establish programmatic targets for HCV elimination in the Republic of Cyprus.
• To model the impact of various interventions on HCV transmission and disease progression.
• To identify key strategies for achieving HCV elimination by 2034.

Main Methods:

• A dynamic, stochastic, individual-based model simulating HCV transmission, disease progression, and care cascade was developed and calibrated using Cypriot data.
• The model differentiated between the general population and the PWID population.
• Various testing, prevention, and treatment strategies were evaluated for their effectiveness until 2034.

Main Results:

• Without new interventions, 75 liver-related deaths and 575 new HCV infections are predicted by 2034.
• Expanded treatment alone yielded modest reductions in CHC prevalence and liver-related deaths.
• Achieving HCV elimination requires diagnosing and treating 3080 individuals by 2034 and increasing harm reduction coverage among PWID to 67% by 2034.

Conclusions:

• HCV elimination is an ambitious public health goal requiring substantial interventions.
• Effective strategies must target both the general population and high-risk groups, particularly PWID.
• Integrated approaches combining treatment, testing, and harm reduction are crucial for HCV eradication.