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A micro-elimination approach to addressing hepatitis C in Turkey

BACKGROUND: In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenari...

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Autores principales: Idilman, Ramazan, Razavi, Homie, Robbins-Scott, Sarah, Akarca, Ulus Salih, Örmeci, Necati, Kaymakoglu, Sabahattin, Aygen, Bilgehan, Tozun, Nurdan, Güner, Rahmet, Bodur, Hurrem, Lazarus, Jeffrey V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093960/
https://www.ncbi.nlm.nih.gov/pubmed/32209103
http://dx.doi.org/10.1186/s12913-020-5019-8
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author Idilman, Ramazan
Razavi, Homie
Robbins-Scott, Sarah
Akarca, Ulus Salih
Örmeci, Necati
Kaymakoglu, Sabahattin
Aygen, Bilgehan
Tozun, Nurdan
Güner, Rahmet
Bodur, Hurrem
Lazarus, Jeffrey V.
author_facet Idilman, Ramazan
Razavi, Homie
Robbins-Scott, Sarah
Akarca, Ulus Salih
Örmeci, Necati
Kaymakoglu, Sabahattin
Aygen, Bilgehan
Tozun, Nurdan
Güner, Rahmet
Bodur, Hurrem
Lazarus, Jeffrey V.
author_sort Idilman, Ramazan
collection PubMed
description BACKGROUND: In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenarios to reach HCV elimination. METHODS: Literature was reviewed for estimates of HCV disease burden in Turkey. They were discussed with stakeholders and used as inputs to develop a disease burden model. The infected population was estimated by sequelae for the years 2015–2030. Three scenarios were developed to evaluate the disease burden in Turkey: a Base 2017 scenario, representing the current standard of care in Turkey; an increased treatment scenario, representing the impact of improved access to DAAs; and a WHO targets scenario, which meet the WHO GHSS viral hepatitis targets of a 65% reduction in mortality and 90% diagnosis rate of the infected population by 2030. RESULTS: At the beginning of 2017, 271,000 viremic infections were estimated. Of these, 58,400 were diagnosed and 10,200 treated. Modelling results showed that, with the current treatment paradigm in Turkey, by 2030 the total number of viremic HCV infections would decline by 35%, while liver-related deaths, hepatocellular carcinoma (HCC), and decompensated cirrhosis would decrease by 10–25%. In the increased treatment scenario, by 2030 viremic HCV infections would decrease by 50%; liver-related deaths, HCC and decompensated cirrhosis would decrease by 45–70%. In the WHO targets scenario, HCV infections would decrease by 80%; sequelae would decrease by 80–85%. Data on disease burden in micro-elimination target subpopulations are largely unavailable. CONCLUSIONS: To meet the WHO Global Health Sector Strategy targets for the elimination of HCV, Turkey needs to increase treatment. Better data are needed as well as countrywide access to DAAs.
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spelling pubmed-70939602020-03-27 A micro-elimination approach to addressing hepatitis C in Turkey Idilman, Ramazan Razavi, Homie Robbins-Scott, Sarah Akarca, Ulus Salih Örmeci, Necati Kaymakoglu, Sabahattin Aygen, Bilgehan Tozun, Nurdan Güner, Rahmet Bodur, Hurrem Lazarus, Jeffrey V. BMC Health Serv Res Research Article BACKGROUND: In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenarios to reach HCV elimination. METHODS: Literature was reviewed for estimates of HCV disease burden in Turkey. They were discussed with stakeholders and used as inputs to develop a disease burden model. The infected population was estimated by sequelae for the years 2015–2030. Three scenarios were developed to evaluate the disease burden in Turkey: a Base 2017 scenario, representing the current standard of care in Turkey; an increased treatment scenario, representing the impact of improved access to DAAs; and a WHO targets scenario, which meet the WHO GHSS viral hepatitis targets of a 65% reduction in mortality and 90% diagnosis rate of the infected population by 2030. RESULTS: At the beginning of 2017, 271,000 viremic infections were estimated. Of these, 58,400 were diagnosed and 10,200 treated. Modelling results showed that, with the current treatment paradigm in Turkey, by 2030 the total number of viremic HCV infections would decline by 35%, while liver-related deaths, hepatocellular carcinoma (HCC), and decompensated cirrhosis would decrease by 10–25%. In the increased treatment scenario, by 2030 viremic HCV infections would decrease by 50%; liver-related deaths, HCC and decompensated cirrhosis would decrease by 45–70%. In the WHO targets scenario, HCV infections would decrease by 80%; sequelae would decrease by 80–85%. Data on disease burden in micro-elimination target subpopulations are largely unavailable. CONCLUSIONS: To meet the WHO Global Health Sector Strategy targets for the elimination of HCV, Turkey needs to increase treatment. Better data are needed as well as countrywide access to DAAs. BioMed Central 2020-03-24 /pmc/articles/PMC7093960/ /pubmed/32209103 http://dx.doi.org/10.1186/s12913-020-5019-8 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Idilman, Ramazan
Razavi, Homie
Robbins-Scott, Sarah
Akarca, Ulus Salih
Örmeci, Necati
Kaymakoglu, Sabahattin
Aygen, Bilgehan
Tozun, Nurdan
Güner, Rahmet
Bodur, Hurrem
Lazarus, Jeffrey V.
A micro-elimination approach to addressing hepatitis C in Turkey
title A micro-elimination approach to addressing hepatitis C in Turkey
title_full A micro-elimination approach to addressing hepatitis C in Turkey
title_fullStr A micro-elimination approach to addressing hepatitis C in Turkey
title_full_unstemmed A micro-elimination approach to addressing hepatitis C in Turkey
title_short A micro-elimination approach to addressing hepatitis C in Turkey
title_sort micro-elimination approach to addressing hepatitis c in turkey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093960/
https://www.ncbi.nlm.nih.gov/pubmed/32209103
http://dx.doi.org/10.1186/s12913-020-5019-8
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