M Matičič1, Andrea Lombardi2, Mario U Mondelli3, Massimo Colombo4. 1. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Ljubljana, Slovenia. 2. Division of Infectious Diseases II and Immunology, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. 3. Division of Infectious Diseases II and Immunology, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. Electronic address: mario.mondelli@unipv.it. 4. Clinical and Research Centre Humanitas Hospital, Rozzano, Italy.
Abstract
BACKGROUND: Chronic hepatitis C virus (HCV) infection affects 71 million people worldwide. The availability of highly efficient direct-acting antivirals has revolutionized the treatment landscape with over 95% cure rates. The WHO has launched a global programme to achieve rather ambitious HCV elimination targets for 2030. OBJECTIVES: This article aims to provide a critical overview of the current HCV elimination programmes in Europe highlighting the elements that should be implemented to achieve elimination and those that are already in place to promote this process. SOURCES: Review of the recently published literature and opinion of experts in the field. CONTENT: Elimination of hepatitis C as a public health threat appears to be a difficult task, which should be subdivided into smaller targets, the so-called micro-elimination goals, to increase chances of success. Macro-elimination strategies based on mass-screening are difficult to implement. Evidence supporting the efficacy of micro-elimination comes from key populations, such as people who inject drugs. HCV elimination is proceeding at different speeds in Europe. Some countries are on target with the WHO's objectives whereas others lack economic support and political advocacy, and have insufficient infrastructures to achieve this. The absence of an effective prophylactic vaccine is hampering the process and should be overcome. IMPLICATIONS: Elimination of hepatitis C worldwide appears plausible, but in several countries probably not within the time frame suggested by the WHO. In the absence of vaccination, universal access to HCV treatment would act as a 'therapeutic' option to reduce transmission, especially in high-risk populations.
BACKGROUND:Chronic hepatitis C virus (HCV) infection affects 71 million people worldwide. The availability of highly efficient direct-acting antivirals has revolutionized the treatment landscape with over 95% cure rates. The WHO has launched a global programme to achieve rather ambitious HCV elimination targets for 2030. OBJECTIVES: This article aims to provide a critical overview of the current HCV elimination programmes in Europe highlighting the elements that should be implemented to achieve elimination and those that are already in place to promote this process. SOURCES: Review of the recently published literature and opinion of experts in the field. CONTENT: Elimination of hepatitis C as a public health threat appears to be a difficult task, which should be subdivided into smaller targets, the so-called micro-elimination goals, to increase chances of success. Macro-elimination strategies based on mass-screening are difficult to implement. Evidence supporting the efficacy of micro-elimination comes from key populations, such as people who inject drugs. HCV elimination is proceeding at different speeds in Europe. Some countries are on target with the WHO's objectives whereas others lack economic support and political advocacy, and have insufficient infrastructures to achieve this. The absence of an effective prophylactic vaccine is hampering the process and should be overcome. IMPLICATIONS: Elimination of hepatitis C worldwide appears plausible, but in several countries probably not within the time frame suggested by the WHO. In the absence of vaccination, universal access to HCV treatment would act as a 'therapeutic' option to reduce transmission, especially in high-risk populations.
Authors: M Maticic; Z Pirnat; A Leicht; R Zimmermann; T Windelinck; M Jauffret-Roustide; E Duffell; T Tammi; E Schatz Journal: Harm Reduct J Date: 2020-11-19
Authors: Keven Lothert; Anna F Offersgaard; Anne F Pihl; Christian K Mathiesen; Tanja B Jensen; Garazi Peña Alzua; Ulrik Fahnøe; Jens Bukh; Judith M Gottwein; Michael W Wolff Journal: Sci Rep Date: 2020-10-01 Impact factor: 4.379
Authors: Stuart McPherson; Shion Gosrani; Sarah Hogg; Preya Patel; Aaron Wetten; Rachael Welton; Kate Hallsworth; Matthew Campbell Journal: BMJ Open Gastroenterol Date: 2020-08
Authors: María B Pisano; Cecilia G Giadans; Diego M Flichman; Viviana E Ré; María V Preciado; Pamela Valva Journal: World J Gastroenterol Date: 2021-07-14 Impact factor: 5.742
Authors: Laura Huiban; Carol Stanciu; Cristina Maria Muzica; Tudor Cuciureanu; Stefan Chiriac; Sebastian Zenovia; Vladut Mirel Burduloi; Oana Petrea; Ana Maria Sîngeap; Irina Gîrleanu; Cătălin Sfarti; Camelia Cojocariu; Anca Trifan Journal: Healthcare (Basel) Date: 2021-05-31