Abstract
Background: The Netherlands strives for hepatitis C virus (HCV) elimination, in accordance with the World Health Organization targets. An accurate estimate when HCV elimination will be reached is elusive. We have embarked on a nationwide HCV elimination project (CELINE) that allowed us to harvest detailed data on the Dutch HCV epidemic. This study aims to provide a well-supported timeline towards HCV elimination in The Netherlands. Methods: A previously published Markov model was used, adopting published data and unpublished CELINE project data. Two main scenarios were devised. In the Status Quo scenario, 2020 diagnosis and treatment levels remained constant in subsequent years. In the Gradual Decline scenario, an annual decrease of 10% in both diagnoses and treatments was implemented, starting in 2020. WHO incidence target was disregarded, due to low HCV incidence in The Netherlands (≤5 per 100,000). Results: Following the Status Quo and Gradual Decline scenarios, The Netherlands would meet WHO’s elimination targets by 2027 and 2032, respectively. From 2015 to 2030, liver-related mortality would be reduced by 97% in the Status Quo and 93% in the Gradual Decline scenario. Compared to the Status Quo scenario, the Gradual Decline scenario would result in 12 excess cases of decompensated cirrhosis, 18 excess cases of hepatocellular carcinoma, and 20 excess cases of liver-related death from 2020–2030. Conclusions: The Netherlands is on track to reach HCV elimination by 2030. However, it is vital that HCV elimination remains high on the agenda to ensure adequate numbers of patients are being diagnosed and treated.
Highlights
Chronic viral hepatitis, if left untreated, leads to considerable morbidity and liverrelated mortality [1]
In the Gradual Decline scenario, in which a yearly 10% reduction in diagnoses and treatments was implemented, World Health Organization (WHO) elimination targets would be met by
The sensitivity analysis showed that a 15% reduction in annual diagnoses and treatments, as opposed to the 10% implemented in the Gradual Decline scenario, pushed back the WHO elimination targets significantly
Summary
If left untreated, leads to considerable morbidity and liverrelated mortality [1]. The World Health Organization (WHO) set ambitious hepatitis B (HBV) and C virus (HCV) elimination targets in 2016. The goal is to eliminate viral hepatitis as a public health threat by 2030, which is defined by the following targets:. A recent modelling study, using the latest data on chronic HCV prevalence, and annual diagnosis and treatment levels in 45 high-income countries, suggests that only Australia, Canada, France, Germany, Iceland, Italy, Japan, Spain, Sweden, Switzerland, and the United Kingdom are currently on track [5]. The Netherlands strives for hepatitis C virus (HCV) elimination, in accordance with the World Health Organization targets. In the Status Quo scenario, 2020 diagnosis and treatment levels remained constant in subsequent years. In the Gradual Decline scenario, an annual decrease of 10%
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