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1.
J Viral Hepat ; 25(9): 1066-1077, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29624813

RESUMO

New drugs for treating hepatitis C have considerably increased the probability of being cured. Treatment uptake, however, is still low. The objectives of this study were to analyse the impact of initiatives that may increase the proportion of infected people on treatment and interventions aimed at reducing the incidence of new infection among people who inject drugs. A compartmental model for Norway was used to simulate hepatitis C and related complications. We analysed 2 different screening initiatives aimed to increase the proportion of infected people on treatment. Interventions aiming at reducing the hepatitis C incidence analysed were opioid substitution therapy (OST), a clean needle and syringe programme and a combination of both. The most cost-effective strategy for increasing hepatitis C treatment uptake was screening by general practitioners while simultaneously allowing for all infected people to be treated. We estimated that this intervention reduces the incidence of hepatitis C by 2030 by 63% compared with the current incidence. The 2 harm reduction strategies both reduced the incidence of hepatitis C by about 70%. Combining an increase in the current clean needles and syringe programme with OST was clearly the most cost-effective option. This strategy would reduce the incidence of hepatitis C by 80% compared with the current incidence by 2030. Thus, interventions to reduce the burden and spread of hepatitis C are cost-effective. Reaching the WHO target of a 90% reduction in hepatitis C incidence by 2030 may be difficult without combining different initiatives.


Assuntos
Antivirais/administração & dosagem , Análise Custo-Benefício , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Controle de Infecções/métodos , Antivirais/economia , Hepatite C/diagnóstico , Hepatite C/tratamento farmacológico , Humanos , Incidência , Controle de Infecções/economia , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Programas de Troca de Agulhas/economia , Programas de Troca de Agulhas/métodos , Noruega/epidemiologia , Tratamento de Substituição de Opiáceos/economia , Tratamento de Substituição de Opiáceos/métodos , Organização Mundial da Saúde
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