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Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment

Overview of attention for article published in Hepatic medicine evidence and research, August 2018
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Title
Hepatitis C in Lebanon: the burden of the disease and the value of comprehensive screening and treatment
Published in
Hepatic medicine evidence and research, August 2018
DOI 10.2147/hmer.s160351
Pubmed ID
Authors

Antoine Abou Rached, Selim Abou Kheir, Jowana Saba, Salwa Assaf, Georges Kassis, Yuri Sanchez Gonzalez, Olivier Ethgen

Abstract

To analyze the hepatitis C virus (HCV) burden in Lebanon and the value of comprehensive screening and treatment for different age groups and fibrosis stages. We used a multicohort, health-state-transition model to project the number of HCV genotype 1 and 4 patients achieving a sustained virologic response 12 weeks after treatment or progressing to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), or liver-related death (LrD) from 2016 to 2036. In the low/medium/high screening scenarios, the proportion of patients screened for HCV was projected to increase to 60%/85%/99%, respectively, by 2036. We analyzed four treatment strategies: 1) no treatment, 2) all-oral direct-acting antivirals (DAAs) given to F3-F4 (CC) patients only, 3) all-oral DAAs to F2-F3-F4 (CC) patients, and 4) all-oral DAAs to all fibrosis patients. Low, medium, and high HCV screening scenarios projected that 3,838, 5,665, and 7,669 individuals will be diagnosed with HCV infection, respectively, from 2016 to 2036, or 40% of those aged 18-39 years, and 60% of those aged 40-80 years. With no treatment, the projected number of patients reaching CC, DCC, HCC, or LrD in 2036 was 899, 147, 131, and 147, respectively, for the 18-39 years age group. For the 40-80 years age group, these projections were substantially greater: 2,828 CC, 736 DCC, 668 HCC, and 958 LrD. The overall economic burden without treatment reached 150 million EUR. However, introducing DAAs for F0-F4 patients was projected to increase the proportion of remaining life-years spent in sustained virologic response 12 weeks after treatment by 43% and 62% compared to DAAs given at F2-F4 or F3-F4 only, respectively. An enhanced screening policy combined with broader access to DAAs can diminish the future clinical and economic burden of HCV in the Lebanese population and, for the middle-aged and elderly, provide the greatest health benefit with net cost savings.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 25 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 5 20%
Student > Doctoral Student 3 12%
Researcher 3 12%
Professor > Associate Professor 3 12%
Student > Master 1 4%
Other 3 12%
Unknown 7 28%
Readers by discipline Count As %
Medicine and Dentistry 10 40%
Economics, Econometrics and Finance 3 12%
Decision Sciences 1 4%
Biochemistry, Genetics and Molecular Biology 1 4%
Social Sciences 1 4%
Other 1 4%
Unknown 8 32%