Robert Flisiak1, Waldemar Halota, Krzysztof Tomasiewicz, Kaja Kostrzewska, Homie A Razavi, Erin E Gower. 1. aDepartment of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok bDepartment of Infectious Diseases and Hepatology, CMUMK Bydgoszcz, Bydgoszcz cDepartment of Infectious Diseases, Medical University of Lublin, Lublin dHTA Consulting, Krakow, Poland eCenter for Disease Analysis, Louisville, Colorado, USA.
Abstract
BACKGROUND AND AIMS: Chronic hepatitis C virus infection is prevalent among 200,000 individuals in Poland; however, few are aware of their condition (30,000 diagnosed) and even fewer are treated (2490 in 2014). This analysis projected future disease burden and developed two treatment scenarios to control or eliminate hepatitis C virus-related disease in Poland. METHODS: Using a modeling approach, the infected population and future disease progression were quantified. Baseline variables included viremic prevalence, age and sex, diagnosis rate, treatment rate, disease progression, and sustained virologic response rates. Data were collected from the literature and through expert interviews. RESULTS: The number of prevalent hepatitis C virus infections is projected to decrease (5%) by 2030. However, the numbers of individuals with compensated and decompensated cirrhosis, and hepatocellular carcinoma are estimated to increase by 40, 55, and 60%, respectively. By increasing sustained virologic response rates to 95% from 2015 onward, and the number of treated cases (from 2490 to 5000), the number of individuals with cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma is projected to remain constant until 2030. A strategy to eliminate chronic hepatitis C virus infection was also considered. To reduce total infections by 90% and mortality by 80%, treatment was increased to 15,000 patients annually. This scenario required the diagnosis of 15,000 new cases (compared with 3000 today). CONCLUSION: A marked reduction in hepatitis C virus-related disease burden is possible, with increased diagnosis and treatment. The results could inform the development of effective disease management in Poland.
BACKGROUND AND AIMS: Chronic hepatitis C virus infection is prevalent among 200,000 individuals in Poland; however, few are aware of their condition (30,000 diagnosed) and even fewer are treated (2490 in 2014). This analysis projected future disease burden and developed two treatment scenarios to control or eliminate hepatitis C virus-related disease in Poland. METHODS: Using a modeling approach, the infected population and future disease progression were quantified. Baseline variables included viremic prevalence, age and sex, diagnosis rate, treatment rate, disease progression, and sustained virologic response rates. Data were collected from the literature and through expert interviews. RESULTS: The number of prevalent hepatitis C virus infections is projected to decrease (5%) by 2030. However, the numbers of individuals with compensated and decompensated cirrhosis, and hepatocellular carcinoma are estimated to increase by 40, 55, and 60%, respectively. By increasing sustained virologic response rates to 95% from 2015 onward, and the number of treated cases (from 2490 to 5000), the number of individuals with cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma is projected to remain constant until 2030. A strategy to eliminate chronic hepatitis C virus infection was also considered. To reduce total infections by 90% and mortality by 80%, treatment was increased to 15,000 patients annually. This scenario required the diagnosis of 15,000 new cases (compared with 3000 today). CONCLUSION: A marked reduction in hepatitis C virus-related disease burden is possible, with increased diagnosis and treatment. The results could inform the development of effective disease management in Poland.
Authors: Ezequiel Ridruejo; Fernando Bessone; Jorge R Daruich; Chris Estes; Adrián C Gadano; Homie Razavi; Federico G Villamil; Marcelo O Silva Journal: World J Hepatol Date: 2016-05-28
Authors: Bożena Walewska-Zielecka; Urszula Religioni; Grzegorz Juszczyk; Zbigniew M Wawrzyniak; Aleksandra Czerw; Piotr Soszyński; Adam Fronczak Journal: Euro Surveill Date: 2017-01-12
Authors: Robert Flisiak; Joanna Pogorzelska; Hanna Berak; Andrzej Horban; Iwona Orłowska; Krzysztof Simon; Ewelina Tuchendler; Grzegorz Madej; Anna Piekarska; Maciej Jabłkowski; Zbigniew Deroń; Włodzimierz Mazur; Marcin Kaczmarczyk; Ewa Janczewska; Arkadiusz Pisula; Jacek Smykał; Krzysztof Nowak; Marek Matukiewicz; Waldemar Halota; Joanna Wernik; Katarzyna Sikorska; Iwona Mozer-Lisewska; Błażej Rozpłochowski; Aleksander Garlicki; Krzysztof Tomasiewicz; Joanna Krzowska-Firych; Barbara Baka-Ćwierz; Wiesław Kryczka; Dorota Zarębska-Michaluk; Iwona Olszok; Anna Boroń-Kaczmarska; Barbara Sobala-Szczygieł; Bronisława Szlauer; Bogumiła Korcz-Ondrzejek; Jerzy Sieklucki; Robert Pleśniak; Agata Ruszała; Barbara Postawa-Kłosińska; Jolanta Citko; Anna Lachowicz-Wawrzyniak; Joanna Musialik; Edyta Jezierska; Witold Dobracki; Beata Dobracka; Jan Hałubiec; Rafał Krygier; Anna Strokowska; Wojciech Chomczyk; Krystyna Witczak-Malinowska Journal: Clin Exp Hepatol Date: 2016-11-28
Authors: Waldemar Halota; Robert Flisiak; Jacek Juszczyk; Piotr Małkowski; Małgorzata Pawłowska; Krzysztof Simon; Krzysztof Tomasiewicz Journal: Clin Exp Hepatol Date: 2017-05-18
Authors: Waldemar Halota; Robert Flisiak; Anna Boroń-Kaczmarska; Jacek Juszczyk; Piotr Małkowski; Małgorzata Pawłowska; Krzysztof Simon; Krzysztof Tomasiewicz Journal: Clin Exp Hepatol Date: 2016-04-07
Authors: Robert Flisiak; Joanna Pogorzelska; Hanna Berak; Andrzej Horban; Iwona Orłowska; Krzysztof Simon; Ewelina Tuchendler; Grzegorz Madej; Anna Piekarska; Maciej Jabłkowski; Zbigniew Deroń; Włodzimierz Mazur; Marcin Kaczmarczyk; Ewa Janczewska; Arkadiusz Pisula; Jacek Smykał; Krzysztof Nowak; Marek Matukiewicz; Waldemar Halota; Joanna Wernik; Katarzyna Sikorska; Iwona Mozer-Lisewska; Błażej Rozpłochowski; Aleksander Garlicki; Krzysztof Tomasiewicz; Joanna Krzowska-Firych; Barbara Baka-Ćwierz; Wiesław Kryczka; Dorota Zarębska-Michaluk; Iwona Olszok; Anna Boroń-Kaczmarska; Barbara Sobala-Szczygieł; Bronisława Szlauer; Bogumiła Korcz-Ondrzejek; Jerzy Sieklucki; Robert Pleśniak; Agata Ruszała; Barbara Postawa-Kłosińska; Jolanta Citko; Anna Lachowicz-Wawrzyniak; Joanna Musialik; Edyta Jezierska; Witold Dobracki; Beata Dobracka; Jan Hałubiec; Rafał Krygier; Anna Strokowska; Wojciech Chomczyk; Krystyna Witczak-Malinowska Journal: Clin Exp Hepatol Date: 2016-11-28