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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Main Author: Houssein H Ayoub (17704359) (author)
Other Authors: Laith J Abu-Raddad (11868161) (author)
Published: 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>
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identifier_str_mv 10.1136/bmjopen-2018-026600
network_acronym_str Manara2
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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