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Modelling the microelimination of chronic hepatitis C in the canton of Bern, Switzerland: Reaching the Swiss Hepatitis Strategy goals despite the impact of the COVID 19 pandemic.
Schorr, Olivier; Blach, Sarah; Thurnheer, Christine; Ruis, Christian; Dufour, Jean-Francois.
  • Schorr O; Master of Public Health, University Basel, University Bern & University Zurich, Zurich, Switzerland.
  • Blach S; Medical Affairs Department, Gilead Sciences, Zurich, Switzerland.
  • Thurnheer C; CDA Foundation, Lafayette, Colorado, United States of America.
  • Ruis C; Department of Infectious Diseases, University Hospital Bern, University of Bern, Bern, Switzerland.
  • Dufour JF; Department of Gastroenterology, Spital STS AG, Thun, Switzerland.
PLoS One ; 17(8): e0272518, 2022.
Article in English | MEDLINE | ID: covidwho-1993489
ABSTRACT
AIMS OF THE STUDY Since 2014, the Swiss Hepatitis Strategy (SHS) has targeted the elimination of Hepatitis C Virus (HCV) in Switzerland. The epidemiology of HCV is diverse across Swiss cantons, therefore cantonal-level screening and treatment strategies should be developed. This study aimed to identify scenarios to achieve HCV elimination in the canton of Bern by 2030.

METHODS:

A preexisting Markov disease burden model was populated with data for Bern, and used to forecast the current and future prevalence of HCV, annual liver-related deaths (LRDs), and incidence of hepatocellular carcinoma and decompensated cirrhosis until 2030. Scenarios were developed to assess the current standard of care and potential long-term impact of the COVID-19 crisis on the HCV infected population. Additionally, potential scenarios for achieving the WHO 2030 targets and the SHS 2025 and 2030 targets (reduction of new cases of HCV, HCV-related mortality and viremic HCV cases) were identified.

RESULTS:

In 2019, there were an estimated 4,600 (95% UI 3,330-4,940) viremic infections in the canton of Bern and 57% (n = 2,600) of viremic cases were diagnosed. This modelling forecasted a 10% increase in LRDs (28 in 2020 to 31 in 2030) with the current standard of care and a 50% increase in LRDs in a scenario assuming long-term delays. To achieve the WHO and SHS targets, the canton of Bern needs to increase the annual number of patients diagnosed (from 90 in 2019 to 250 per year in 2022-2024 [WHO], or 500 per year in 2022-2025 [SHS]) and treated (from 130 in 2019 to 340 per year in 2022-2024 [WHO] or 670 per year in 2022-2025 [SHS]).

CONCLUSIONS:

The SHS goals and the WHO targets for HCV elimination can be achieved in the Swiss canton of Bern by 2030; however, not at the current pace of screening, linkage to care and treatment.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatitis C / Hepatitis C, Chronic / COVID-19 / Hepatitis A / Liver Neoplasms Type of study: Experimental Studies / Observational study Limits: Humans Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0272518

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatitis C / Hepatitis C, Chronic / COVID-19 / Hepatitis A / Liver Neoplasms Type of study: Experimental Studies / Observational study Limits: Humans Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0272518