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Hepatitis C disease burden and strategies for elimination by 2030 in Brazil. A mathematical modeling approach.
Benzaken, Adele Schwartz; Girade, Renato; Catapan, Elisa; Pereira, Gerson Fernando Mendes; Almeida, Elton Carlos de; Vivaldini, Simone; Fernandes, Neide; Razavi, Homie; Schmelzer, Jonathan; Ferraz, Maria Lucia; Ferreira, Paulo Roberto Abrão; Pessoa, Mario Guimarães; Martinelli, Ana; Souto, Francisco José Dutra; Walsh, Nick; Mendes-Correa, Maria Cassia.
Afiliação
  • Benzaken AS; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil; Tropical Medicina Foundation Heitor Vieira Dourado, Manaus, Amazon, AM, Brazil.
  • Girade R; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Catapan E; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Pereira GFM; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Almeida EC; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Vivaldini S; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Fernandes N; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil.
  • Razavi H; Center for Disease Analysis Foundation, Polaris Observatory, Lafayette, CO, USA.
  • Schmelzer J; Center for Disease Analysis Foundation, Polaris Observatory, Lafayette, CO, USA.
  • Ferraz ML; Federal University of São Paulo, Gastroenterology Division, São Paulo, SP, Brazil.
  • Ferreira PRA; Federal University of São Paulo, Infectious Diseases Division, São Paulo, SP, Brazil.
  • Pessoa MG; University of São Paulo School of Medicine, Division of Gastroenterology and Hepatology, São Paulo, SP, Brazil.
  • Martinelli A; University of São Paulo School of Medicine, Department of Medicine, Ribeirão Preto, São Paulo, SP, Brazil.
  • Souto FJD; Federal University of Mato Grosso, School of Medicine, Cuiabá, MT, Brazil.
  • Walsh N; Pan American Health Organization (PAHO), Department of Communicable Diseases and Environmental Determinants of Health, Washington, DC, USA.
  • Mendes-Correa MC; Ministry of Health, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Department of Surveillance, Brasília, DF, Brazil; University of São Paulo School of Medicine, Lim/52, Tropical Medicine Institute, São Paulo, SP, Brazil. Electronic address: cassiamc@uol.com.br.
Braz J Infect Dis ; 23(3): 182-190, 2019.
Article em En | MEDLINE | ID: mdl-31145876
INTRODUCTION AND AIM: Hepatitis C is a key challenge to public health in Brazil. The objective of this paper was to describe the Brazilian strategy for hepatitis C to meet the 2030 elimination goal proposed by World Health Organization (WHO). METHODS: A mathematical modeling approach was used to estimate the current HCV-infected Brazilian population, and to evaluate the relative costs of two different scenarios to address HCV disease burden in Brazil: (1) if no further changes are made to the HCV treatment program in Brazil; (2) where the WHO targets for 2030 elimination are met through diagnosis and treatment efforts peaking before 2024. RESULTS: An anti-HCV prevalence of 0.53% was calculated for the total population. It was estimated that the number of HCV-RNA+ individuals in Brazil in 2017 was 632,000 (0.31% of the population). Scale-up of treatment and diagnosis over time will be necessary in order to achieve WHO targets beginning in 2018. Direct costs (diagnostic, treatment and healthcare costs) are projected to increase significantly during the scale-up of treatment and diagnosis in the initial years of the intervention scenario, but then fall below the base case on an annual basis by 2025-2036, once HCV is eliminated, due to health sectors savings from the prevention of HCV liver-related morbidity and mortality. CONCLUSION: Achieving the WHO targets is technically feasible in Brazil with a scale-up of treatment and diagnosis over time, beginning in 2018. However, elimination of hepatitis C requires policy changes to substantially scale-up prevention, screening and treatment of HCV, together with public health advocacy to raise awareness among affected populations and healthcare providers.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hepatite C / Hepacivirus / Erradicação de Doenças Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hepatite C / Hepacivirus / Erradicação de Doenças Idioma: En Ano de publicação: 2019 Tipo de documento: Article