Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections
<h3>Objective</h3><p dir="ltr">Direct-acting antivirals have opened an opportunity for controlling hepatitis C virus (HCV) infection in Pakistan, where 10% of the global infection burden is found. We aimed to evaluate the implications of five treatment programme scenarios...
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2019
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| author | Houssein H Ayoub (17704359) |
| author2 | Laith J Abu-Raddad (11868161) |
| author2_role | author |
| author_facet | Houssein H Ayoub (17704359) Laith J Abu-Raddad (11868161) |
| author_role | author |
| dc.creator.none.fl_str_mv | Houssein H Ayoub (17704359) Laith J Abu-Raddad (11868161) |
| dc.date.none.fl_str_mv | 2019-05-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1136/bmjopen-2018-026600 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Treatment_as_prevention_for_hepatitis_C_virus_in_Pakistan_mathematical_modelling_projections/25907812 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Health sciences Public health Hepatitis C virus (HCV) Direct-acting antivirals HCV treatment as prevention (HCV-TasP) Treatment program evaluation Mathematical modeling Epidemiological indicators Treatment coverage |
| dc.title.none.fl_str_mv | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Objective</h3><p dir="ltr">Direct-acting antivirals have opened an opportunity for controlling hepatitis C virus (HCV) infection in Pakistan, where 10% of the global infection burden is found. We aimed to evaluate the implications of five treatment programme scenarios for HCV treatment as prevention (HCV-TasP) in Pakistan.</p><h3>Design</h3><p dir="ltr">An age-structured mathematical model was used to evaluate programme impact using epidemiological and programme indicators.</p><h3>Setting</h3><p dir="ltr">Total Pakistan population.</p><h3>Participants</h3><p dir="ltr">Total Pakistan HCV-infected population.</p><h3>Interventions</h3><p dir="ltr">HCV treatment programme scenarios from 2018 up to 2030.</p><h3>Results</h3><p dir="ltr">By 2030 across the five HCV-TasP scenarios, 0.6–7.3 million treatments were administered, treatment coverage reached between 3.7% and 98.7%, prevalence of chronic infection reached 2.4%–0.03%, incidence reduction ranged between 41% and 99%, program-attributed reduction in incidence rate ranged between 7.2% and 98.5% and number of averted infections ranged between 126 221 and 750 547. Annual incidence rate reduction in the first decade of the programme was around 6%–18%. Number of treatments needed to prevent one new infection ranged between 4.7–9.8, at a drug cost of about US$900. Cost of the programme by 2030, in the most ambitious elimination scenario, reached US$708 million. Stipulated WHO target for 2030 cannot be accomplished without scaling up treatment to 490 000 per year, and maintaining it for a decade.</p><h3>Conclusion</h3><p dir="ltr">HCV-TasP is a highly impactful and potent approach to control Pakistan’s HCV epidemic and achieve elimination by 2030.</p><h2>Other Information</h2><p dir="ltr">Published in: BMJ Open<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1136/bmjopen-2018-026600" target="_blank">https://dx.doi.org/10.1136/bmjopen-2018-026600</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_dcfaa332fce41ccc060a117a819ca190 |
| identifier_str_mv | 10.1136/bmjopen-2018-026600 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25907812 |
| publishDate | 2019 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projectionsHoussein H Ayoub (17704359)Laith J Abu-Raddad (11868161)Health sciencesPublic healthHepatitis C virus (HCV)Direct-acting antiviralsHCV treatment as prevention (HCV-TasP)Treatment program evaluationMathematical modelingEpidemiological indicatorsTreatment coverage<h3>Objective</h3><p dir="ltr">Direct-acting antivirals have opened an opportunity for controlling hepatitis C virus (HCV) infection in Pakistan, where 10% of the global infection burden is found. We aimed to evaluate the implications of five treatment programme scenarios for HCV treatment as prevention (HCV-TasP) in Pakistan.</p><h3>Design</h3><p dir="ltr">An age-structured mathematical model was used to evaluate programme impact using epidemiological and programme indicators.</p><h3>Setting</h3><p dir="ltr">Total Pakistan population.</p><h3>Participants</h3><p dir="ltr">Total Pakistan HCV-infected population.</p><h3>Interventions</h3><p dir="ltr">HCV treatment programme scenarios from 2018 up to 2030.</p><h3>Results</h3><p dir="ltr">By 2030 across the five HCV-TasP scenarios, 0.6–7.3 million treatments were administered, treatment coverage reached between 3.7% and 98.7%, prevalence of chronic infection reached 2.4%–0.03%, incidence reduction ranged between 41% and 99%, program-attributed reduction in incidence rate ranged between 7.2% and 98.5% and number of averted infections ranged between 126 221 and 750 547. Annual incidence rate reduction in the first decade of the programme was around 6%–18%. Number of treatments needed to prevent one new infection ranged between 4.7–9.8, at a drug cost of about US$900. Cost of the programme by 2030, in the most ambitious elimination scenario, reached US$708 million. Stipulated WHO target for 2030 cannot be accomplished without scaling up treatment to 490 000 per year, and maintaining it for a decade.</p><h3>Conclusion</h3><p dir="ltr">HCV-TasP is a highly impactful and potent approach to control Pakistan’s HCV epidemic and achieve elimination by 2030.</p><h2>Other Information</h2><p dir="ltr">Published in: BMJ Open<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1136/bmjopen-2018-026600" target="_blank">https://dx.doi.org/10.1136/bmjopen-2018-026600</a></p>2019-05-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1136/bmjopen-2018-026600https://figshare.com/articles/journal_contribution/Treatment_as_prevention_for_hepatitis_C_virus_in_Pakistan_mathematical_modelling_projections/25907812CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/259078122019-05-01T00:00:00Z |
| spellingShingle | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections Houssein H Ayoub (17704359) Health sciences Public health Hepatitis C virus (HCV) Direct-acting antivirals HCV treatment as prevention (HCV-TasP) Treatment program evaluation Mathematical modeling Epidemiological indicators Treatment coverage |
| status_str | publishedVersion |
| title | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| title_full | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| title_fullStr | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| title_full_unstemmed | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| title_short | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| title_sort | Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections |
| topic | Health sciences Public health Hepatitis C virus (HCV) Direct-acting antivirals HCV treatment as prevention (HCV-TasP) Treatment program evaluation Mathematical modeling Epidemiological indicators Treatment coverage |