Impact of COVID-19 on global HCV elimination efforts

JOURNAL OF HEPATOLOGY

卷:74

Article

Blach, Sarah¹  Kondili, Loreta A.²  Aghemo, Alessio^3,4  Cai, Zongzhen¹  Dugan, Ellen¹  Estes, Chris¹  Gamkrelidze, Ivane¹  Ma, Siya¹  Pawlotsky, Jean-Michel^5,6  Razavi-Shearer, Devin¹  Razavi, Homie¹  Waked, Imam⁷  Zeuzem, Stefan⁸  Craxi, Antonio⁹ 

[1] Ctr Dis Anal Fdn, 1120 W South Boulder Rd,Suite 102, Lafayette, CO 80026 USA

[2] Ist Super Sanita, Natl Ctr Global Hlth, Rome, Italy

[3] Humanitas Clin & Res Ctr, IRCCS, Internal Med & Hepatol Div, Milan, Italy

[4] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[5] Hop Henri Mondor, Dept Virol, Natl Reference Ctr Viral Hepatitis B C&D, Creteil, France

[6] INSERM, U955, Creteil, France

[7] Menoufia Univ, Natl Liver Inst, Al Minufya, Egypt

[8] Goethe Univ Hosp, Internal Med Dept, Frankfurt, Germany

[9] Univ Palermo, Dept Internal Med & Med Specialties, Gastroenterol & Hepatol Unit, Palermo, Italy

关键词: COVID-19;    Hepatitis C;    Viral hepatitis elimination;    Mathematical modelling;   

DOI  :  10.1016/j.jhep.2020.07.042

来源: Elsevier

【 摘 要 】

Background & Aims: Coronavirus disease 2019 (COVID-19) has placed a significant strain on national healthcare systems at a critical moment in the context of hepatitis elimination. Mathematical models can be used to evaluate the possible impact of programmatic delays on hepatitis disease burden. The objective of this analysis was to evaluate the incremental change in HCV liver-related deaths and liver cancer, following a 3-month, 6-month, or 1-year hiatus in hepatitis elimination programs. Methods: Previously developed models were adapted for 110 countries to include a status quo or 'no delay' scenario and a '1-year delay' scenario assuming significant disruption in interventions (screening, diagnosis, and treatment) in the year 2020. Annual country-level model outcomes were extracted, and weighted averages were used to calculate regional (WHO and World Bank Income Group) and global estimates from 2020 to 2030. The incremental annual change in outcomes was calculated by subtracting the 'no-delay' estimates from the '1-year delay' estimates. Results: The '1-year delay' scenario resulted in 44,800 (95% uncertainty interval [UI]: 43,800-49,300) excess hepatocellular carcinoma cases and 72,300 (95% UI: 70,600-79,400) excess liver-related deaths, relative to the 'no-delay' scenario globally, from 2020 to 2030. Most missed treatments would be in lower-middle income countries, whereas most excess hepatocellular carcinoma and liver-related deaths would be among high-income countries. Conclusions: The impact of COVID-19 extends beyond the direct morbidity and mortality associated with exposure and infection. To mitigate the impact on viral hepatitis programming and reduce excess mortality from delayed treatment, policy makers should prioritize hepatitis programs as soon as it becomes safe to do so. Lay Summary: COVID-19 has resulted in many hepatitis elimination programs slowing or stopping altogether. A 1-year delay in hepatitis diagnosis and treatment could result in an additional 44,800 liver cancers and 72,300 deaths from HCV globally by 2030. Countries have committed to hepatitis elimination by 2030, so attention should shift back to hepatitis programming as soon as it becomes appropriate to do so. (C) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

【 授权许可】

Free