Building a hepatitis C virus treatment strategy to achieve the 2030 vision for Saudi Arabia.

Sir,

It is with great interest that I read the recent publication by Aljumah and his group regarding the disease burden and treatment strategy for hepatitis C virus (HCV) infection in Saudi Arabia, especially within the context of the paradigm shift toward a high cure rate of the virus.[1]

In 2011, the estimated prevalence rate of viremic HCV cases was at 0.5%, with only a slight projected increase in the prevalence of viremic cases, from 100,000 in 2011 to 103,000 by 2030, with current treatment strategies using highly effective therapies.[12] The authors explain in detail the future burden of liver-related mortality and other sequela related to HCV infection.[1] Although this is a very insightful paper which might help us to predict the potential economic burden of HCV infection on our healthcare system, the cost-effective benefit of pursuing interventions that have a high efficacy in reducing the prevalence of HCV cases has not been addressed. Specifically, an aggressive treatment strategy might lead to a significant reduction in the number of HCV cases by 2030, eventually lowering the HCV-related burden on public and private healthcare sectors in Saudi Arabia.

The second point is you might argue that there is a rapid increase in nonalcoholic fatty liver disease, compared to HCV, due to the high prevalence of diabetes and obesity in Saudi Arabia. Therefore, it could be argued that more resources should be focused on this group due to the potential benefit not only in reducing liver-related complications but also in decreasing the prevalence of obesity-related diseases such as coronary artery disease, obstructive sleep apnea, and other complications, which could also provide significant benefits to health care.[3]

A cost-effective analysis is warranted, taking into account the constraints in the country's gross domestic product brought about by significant decreases in revenues, in order to derive a comprehensive understanding of the net benefits of pursuing an aggressive treatment course for HCV infection.[4] A cost-effective analysis would make the greatest contribution to health policy formulation, providing policy makers with a clear understanding of the principles and potential benefits of such intervention strategies.[4] A cost-effective analysis would help to resolve debates regarding resource allocations for the health sector.

The authors of this paper make a distinguished effort in providing us with an insightful paper regarding the potential burden of HCV-related liver disease in Saudi Arabia and encourage completion of a cost-effective analysis to support the action to achieve desired outcomes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.