Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment

Antoine Abou Rached,1 Selim Abou Kheir,1 Jowana Saba,1 Salwa Assaf,2 Georges Kassis,3 Yuri Sanchez Gonzalez,4 Olivier Ethgen5,6 1Faculty of Medicine, School of Medicine, Lebanese University, Beirut, Lebanon; 2Abbvie Biopharmaceuticals GmbH, Beirut, Lebanon; 3Abbvie Biopharmaceuticals, Paris, France;...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Abou Rached A, Abou Kheir S, Saba J, Assaf S, Kassis G, Sanchez Gonzalez Y, Ethgen O
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Hepatitis C epidemiology burden of disease screening Lebanon. Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/8739804e6ef54baf9f625f6318463cce
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8739804e6ef54baf9f625f6318463cce
record_format	dspace
spelling	oai:doaj.org-article:8739804e6ef54baf9f625f6318463cce2021-12-02T03:49:28ZHepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment1179-1535https://doaj.org/article/8739804e6ef54baf9f625f6318463cce2018-08-01T00:00:00Zhttps://www.dovepress.com/hepatitis-c-in-lebanon-the-burden-of-the-disease-and-the-value-of-comp-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Antoine Abou Rached,1 Selim Abou Kheir,1 Jowana Saba,1 Salwa Assaf,2 Georges Kassis,3 Yuri Sanchez Gonzalez,4 Olivier Ethgen5,6 1Faculty of Medicine, School of Medicine, Lebanese University, Beirut, Lebanon; 2Abbvie Biopharmaceuticals GmbH, Beirut, Lebanon; 3Abbvie Biopharmaceuticals, Paris, France; 4AbbVie Inc., North Chicago, IL, USA; 5SERFAN Innovation, Namur, Belgium; 6Department of Public Health, Epidemiology and Health Economics, University de Liège, Liège, Belgium Purpose: To analyze the hepatitis C virus (HCV) burden in Lebanon and the value of comprehensive screening and treatment for different age groups and fibrosis stages. Methods: We used a multicohort, health-state-transition model to project the number of HCV genotype 1 and 4 patients achieving a sustained virologic response 12 weeks after treatment or progressing to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), or liver-related death (LrD) from 2016 to 2036. In the low/medium/high screening scenarios, the proportion of patients screened for HCV was projected to increase to 60%/85%/99%, respectively, by 2036. We analyzed four treatment strategies: 1) no treatment, 2) all-oral direct-acting antivirals (DAAs) given to F3–F4 (CC) patients only, 3) all-oral DAAs to F2–F3–F4 (CC) patients, and 4) all-oral DAAs to all fibrosis patients. Results: Low, medium, and high HCV screening scenarios projected that 3,838, 5,665, and 7,669 individuals will be diagnosed with HCV infection, respectively, from 2016 to 2036, or 40% of those aged 18–39 years, and 60% of those aged 40–80 years. With no treatment, the projected number of patients reaching CC, DCC, HCC, or LrD in 2036 was 899, 147, 131, and 147, respectively, for the 18–39 years age group. For the 40–80 years age group, these projections were substantially greater: 2,828 CC, 736 DCC, 668 HCC, and 958 LrD. The overall economic burden without treatment reached 150 million EUR. However, introducing DAAs for F0–F4 patients was projected to increase the proportion of remaining life-years spent in sustained virologic response 12 weeks after treatment by 43% and 62% compared to DAAs given at F2–F4 or F3–F4 only, respectively. Conclusion: An enhanced screening policy combined with broader access to DAAs can diminish the future clinical and economic burden of HCV in the Lebanese population and, for the middle-aged and elderly, provide the greatest health benefit with net cost savings. Keywords: hepatitis C, epidemiology, burden of disease, screening, Lebanon, HCV treatment, screening and treatment policiesAbou Rached AAbou Kheir SSaba JAssaf SKassis GSanchez Gonzalez YEthgen ODove Medical PressarticleHepatitis Cepidemiologyburden of diseasescreeningLebanon.Diseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 10, Pp 73-85 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hepatitis C epidemiology burden of disease screening Lebanon. Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Hepatitis C epidemiology burden of disease screening Lebanon. Diseases of the digestive system. Gastroenterology RC799-869 Abou Rached A Abou Kheir S Saba J Assaf S Kassis G Sanchez Gonzalez Y Ethgen O Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
description	Antoine Abou Rached,1 Selim Abou Kheir,1 Jowana Saba,1 Salwa Assaf,2 Georges Kassis,3 Yuri Sanchez Gonzalez,4 Olivier Ethgen5,6 1Faculty of Medicine, School of Medicine, Lebanese University, Beirut, Lebanon; 2Abbvie Biopharmaceuticals GmbH, Beirut, Lebanon; 3Abbvie Biopharmaceuticals, Paris, France; 4AbbVie Inc., North Chicago, IL, USA; 5SERFAN Innovation, Namur, Belgium; 6Department of Public Health, Epidemiology and Health Economics, University de Liège, Liège, Belgium Purpose: To analyze the hepatitis C virus (HCV) burden in Lebanon and the value of comprehensive screening and treatment for different age groups and fibrosis stages. Methods: We used a multicohort, health-state-transition model to project the number of HCV genotype 1 and 4 patients achieving a sustained virologic response 12 weeks after treatment or progressing to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), or liver-related death (LrD) from 2016 to 2036. In the low/medium/high screening scenarios, the proportion of patients screened for HCV was projected to increase to 60%/85%/99%, respectively, by 2036. We analyzed four treatment strategies: 1) no treatment, 2) all-oral direct-acting antivirals (DAAs) given to F3–F4 (CC) patients only, 3) all-oral DAAs to F2–F3–F4 (CC) patients, and 4) all-oral DAAs to all fibrosis patients. Results: Low, medium, and high HCV screening scenarios projected that 3,838, 5,665, and 7,669 individuals will be diagnosed with HCV infection, respectively, from 2016 to 2036, or 40% of those aged 18–39 years, and 60% of those aged 40–80 years. With no treatment, the projected number of patients reaching CC, DCC, HCC, or LrD in 2036 was 899, 147, 131, and 147, respectively, for the 18–39 years age group. For the 40–80 years age group, these projections were substantially greater: 2,828 CC, 736 DCC, 668 HCC, and 958 LrD. The overall economic burden without treatment reached 150 million EUR. However, introducing DAAs for F0–F4 patients was projected to increase the proportion of remaining life-years spent in sustained virologic response 12 weeks after treatment by 43% and 62% compared to DAAs given at F2–F4 or F3–F4 only, respectively. Conclusion: An enhanced screening policy combined with broader access to DAAs can diminish the future clinical and economic burden of HCV in the Lebanese population and, for the middle-aged and elderly, provide the greatest health benefit with net cost savings. Keywords: hepatitis C, epidemiology, burden of disease, screening, Lebanon, HCV treatment, screening and treatment policies
format	article
author	Abou Rached A Abou Kheir S Saba J Assaf S Kassis G Sanchez Gonzalez Y Ethgen O
author_facet	Abou Rached A Abou Kheir S Saba J Assaf S Kassis G Sanchez Gonzalez Y Ethgen O
author_sort	Abou Rached A
title	Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
title_short	Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
title_full	Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
title_fullStr	Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
title_full_unstemmed	Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
title_sort	hepatitis c in lebanon: the burden of the disease and the value of comprehensive screening and treatment
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/8739804e6ef54baf9f625f6318463cce
work_keys_str_mv	AT abouracheda hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT aboukheirs hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT sabaj hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT assafs hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT kassisg hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT sanchezgonzalezy hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment AT ethgeno hepatitiscinlebanontheburdenofthediseaseandthevalueofcomprehensivescreeningandtreatment
_version_	1718401605590581248

Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment

Ejemplares similares