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Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study

BACKGROUND: Direct-acting antivirals opened an opportunity for eliminating hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the region most affected by HCV infection. Impact of HCV treatment as prevention (HCV-TasP) was investigated in 19 MENA countries. METHODS: An age-...

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Autores principales: Ayoub, Houssein H., Mahmud, Sarwat, Chemaitelly, Hiam, Abu-Raddad, Laith J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374017/
https://www.ncbi.nlm.nih.gov/pubmed/37521971
http://dx.doi.org/10.3389/fpubh.2023.1187786
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author Ayoub, Houssein H.
Mahmud, Sarwat
Chemaitelly, Hiam
Abu-Raddad, Laith J.
author_facet Ayoub, Houssein H.
Mahmud, Sarwat
Chemaitelly, Hiam
Abu-Raddad, Laith J.
author_sort Ayoub, Houssein H.
collection PubMed
description BACKGROUND: Direct-acting antivirals opened an opportunity for eliminating hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the region most affected by HCV infection. Impact of HCV treatment as prevention (HCV-TasP) was investigated in 19 MENA countries. METHODS: An age-structured mathematical model was used to assess program impact using epidemiologic and programming measures. The model was fitted to a database of systematically gathered HCV antibody prevalence data. Two main scenarios were investigated for the treatment roll-out to achieve (i) 80% reduction in HCV incidence by 2030, and (ii) incidence rate < 1 per 100,000 person-years by 2030. RESULTS: In the target-80%-incidence-reduction scenario, number of treatments administrated by 2030 ranged from 2,610 in Lebanon to 180,416 in Sudan with a median of 53,079, and treatment coverage ranged between 40.2 and 78.4% with a median of 60.4%. By 2030, prevalence of chronic infection ranged between 0.0 and 0.3% with a median of 0.1%, and incidence rate, per 100,000 person-years, ranged between 0.9 and 16.3 with a median of 3.2. Program-attributed reduction in incidence rate ranged between 47.8 and 81.9% with a median of 68.5%, and number of averted infections ranged between 401 and 68,499 with a median of 8,703. Number of treatments needed to prevent one new infection ranged from 1.7 in Oman to 25.9 in Tunisia with a median of 6.5. In the target incidence rate  < 1 per 100,000 person-years scenario, number of treatments administrated by 2030 ranged from 3,470 in Lebanon to 211,912 in Sudan with a median of 54,479, and treatment coverage ranged between 55.5 and 95.9% with a median of 87.5%. By 2030, prevalence of chronic infection was less than 0.1%, and incidence rate, per 100,000 person-years, reached less than 1. Program-attributed reduction in incidence rate ranged between 61.0 and 97.5% with a median of 90.7%, and number of averted infections ranged between 559 and 104,315 with a median of 12,158. Number of treatments needed to prevent one new infection ranged from 1.3 in Oman to 25.9 in Tunisia with a median of 5.5. CONCLUSION: HCV-TasP is an effective and indispensable prevention intervention to control MENA’s HCV epidemic and to achieve elimination by 2030.
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spelling pubmed-103740172023-07-28 Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study Ayoub, Houssein H. Mahmud, Sarwat Chemaitelly, Hiam Abu-Raddad, Laith J. Front Public Health Public Health BACKGROUND: Direct-acting antivirals opened an opportunity for eliminating hepatitis C virus (HCV) infection in the Middle East and North Africa (MENA), the region most affected by HCV infection. Impact of HCV treatment as prevention (HCV-TasP) was investigated in 19 MENA countries. METHODS: An age-structured mathematical model was used to assess program impact using epidemiologic and programming measures. The model was fitted to a database of systematically gathered HCV antibody prevalence data. Two main scenarios were investigated for the treatment roll-out to achieve (i) 80% reduction in HCV incidence by 2030, and (ii) incidence rate < 1 per 100,000 person-years by 2030. RESULTS: In the target-80%-incidence-reduction scenario, number of treatments administrated by 2030 ranged from 2,610 in Lebanon to 180,416 in Sudan with a median of 53,079, and treatment coverage ranged between 40.2 and 78.4% with a median of 60.4%. By 2030, prevalence of chronic infection ranged between 0.0 and 0.3% with a median of 0.1%, and incidence rate, per 100,000 person-years, ranged between 0.9 and 16.3 with a median of 3.2. Program-attributed reduction in incidence rate ranged between 47.8 and 81.9% with a median of 68.5%, and number of averted infections ranged between 401 and 68,499 with a median of 8,703. Number of treatments needed to prevent one new infection ranged from 1.7 in Oman to 25.9 in Tunisia with a median of 6.5. In the target incidence rate  < 1 per 100,000 person-years scenario, number of treatments administrated by 2030 ranged from 3,470 in Lebanon to 211,912 in Sudan with a median of 54,479, and treatment coverage ranged between 55.5 and 95.9% with a median of 87.5%. By 2030, prevalence of chronic infection was less than 0.1%, and incidence rate, per 100,000 person-years, reached less than 1. Program-attributed reduction in incidence rate ranged between 61.0 and 97.5% with a median of 90.7%, and number of averted infections ranged between 559 and 104,315 with a median of 12,158. Number of treatments needed to prevent one new infection ranged from 1.3 in Oman to 25.9 in Tunisia with a median of 5.5. CONCLUSION: HCV-TasP is an effective and indispensable prevention intervention to control MENA’s HCV epidemic and to achieve elimination by 2030. Frontiers Media S.A. 2023-07-13 /pmc/articles/PMC10374017/ /pubmed/37521971 http://dx.doi.org/10.3389/fpubh.2023.1187786 Text en Copyright © 2023 Ayoub, Mahmud, Chemaitelly and Abu-Raddad. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Ayoub, Houssein H.
Mahmud, Sarwat
Chemaitelly, Hiam
Abu-Raddad, Laith J.
Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title_full Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title_fullStr Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title_full_unstemmed Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title_short Treatment as prevention for hepatitis C virus in the Middle East and North Africa: a modeling study
title_sort treatment as prevention for hepatitis c virus in the middle east and north africa: a modeling study
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374017/
https://www.ncbi.nlm.nih.gov/pubmed/37521971
http://dx.doi.org/10.3389/fpubh.2023.1187786
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