Roadmap to control HBV and HDV epidemics in China

JOURNAL OF THEORETICAL BIOLOGY

卷:423

Article

Goyal, Ashish¹  Murray, John M.¹ 

[1] UNSW Australia, Sch Math & Stat, Sydney, NSW 2052, Australia

关键词: Health economics;    Epidemiology;    Public policy;    Sexually transmitted infection;   

DOI  :  10.1016/j.jtbi.2017.04.007

来源: Elsevier

【 摘 要 】

Purpose: Hepatitis B virus (HBV) is endemic in China. Almost 10% of HBV infected individuals are also infected with hepatitis D virus (HDV) which has a 5-10 times higher mortality rate than HBV mono infection. The aim of this manuscript is to devise strategies that can not only control HBV infections but also HDV infections in China under the current health care budget in an optimal manner. Methods: Using a mathematical model, an annual budget of $10 billion was optimally allocated among five interventions namely, testing and HBV adult vaccination, treatment for mono-infected and dually infected individuals, second line treatment for HBV mono-infections, and awareness programs. Results: We determine that the optimal strategy is to test and treat both infections as early as possible while applying awareness programs at full intensity. Under this strategy, an additional 19.8 million HBV, 1.9 million HDV infections and 0.25 million lives will be saved over the next 10 years at a cost-savings of $79 billion than performing no intervention. Introduction of second line treatment does not add a significant economic burden yet prevents 1.4 million new HBV infections and 15,000 new HDV infections. Conclusion: Test and treatment programs are highly efficient in reducing HBV and HDV prevalence in the population. Under the current health budget in China, not only test and treat programs but awareness programs and second line treatment can also be implemented that minimizes prevalence and mortality, and maximizes economic benefits. (C) 2017 Elsevier Ltd. All rights reserved.

【 授权许可】

Free