HCV diagnoses must triple to meet WHO elimination goals by 2030
Most countries, especially high-income countries, are running out of patients with hepatitis C to treat due to low diagnosis rates, according to data presented at the World Hepatitis Summit 2017 in São Paulo, Brazil.
“Only with a combination of political will, increased access to diagnostics and greater awareness of the disease can we vastly improve diagnosis rates,” Homie Razavi, PhD, managing director of the Center for Disease Analysis, said in a press release from the meeting. “Unless we crack this diagnosis challenge, the ambitious elimination targets for hepatitis set by WHO will remain out of reach for decades to come.”
Data from the Center for Disease Analysis Foundation’s Polaris Observatory showed that, globally, new diagnoses of HCV need to triple from 1.5 million to 4.5 million each year and treatment rates need to increase from 1.76 million to 5 million to achieve the WHO elimination targets by 2030.
Researchers calculated that the number of global HCV cases was 69,283,000 up to 2016 and 68,010,000 in 2017 based on current trends. To reach the WHO elimination targets, the number of diagnosed cases in 2017 should be 67,882,000.
While in 2017 the current number of HCV diagnoses is 12,858,000 based on current trends — a higher rate than the necessary 12,730,000 to meet the WHO elimination targets — the researchers project that the number of diagnoses in 2018 will be 12,541,000 vs. the necessary 14,358,000 and will continue to fall short of the necessary mark by 2,000,000 over the next few years.
According to Razavi and colleagues, the countries with the highest prevalence include Russia (3%), Taiwan (2%), Kuwait (2%), Latvia (2%), Equatorial Guinea (2%), Italy (1%), United Arab Emirates (1%), Greece (1%) and Israel (1%).
However, the researchers found some regions throughout the world that showed distinct efforts toward HCV elimination.
In one case, the village of El Othmanya in Egypt screened its entire population of 3,500 people and found 215 cases of HCV. This same methodology was extended to 50 villages in 26 regions of Egypt to screen 30 million of the country’s 90 million population by the end of 2018.
In the Northland region of New Zealand, the local health board provided 300 New Zealand dollars to general practices for each patient successfully diagnosed and treated for HCV. This allowed practices to waive patient co-payment fees. Additionally, the country recently announced a nationwide program to pay for medical transport costs of patients with HCV.
In the U.S., Mount Sinai Hospital in Chicago screened all patients aged 16 years or older who entered the emergency department and needed blood tests as part of a program that was run until March 2017. The program resulted in nearly 200 new diagnoses. Similarly, emergency department screening has detected nearly 70% of new cases in the Cherokee Nation American Indian Tribe in Oklahoma. Their program also includes offering HCV screening during doctor and dentist appointments.
“Hepatitis C is a silent killer and there are nearly 70 million people worldwide who need treatment, but we must find them,” Charles Gore, president of the World Hepatitis Alliance, said in the press release. “Yet, because of the historic lack of national and international investment in viral hepatitis programs the vast majority of patients with hepatitis C — some 80% — remain undiagnosed, and less than 5% are able to access treatment.” – by Talitha Bennett
Razavi H, et al. Countries must diagnose three times more patients to meet WHO’s elimination targets. Presented at: The World Hepatitis Summit 2017; Nov. 1-3, 2017; São Paulo, Brazil.
Disclosure: Healio.com/Hepatology was unable to determine relevant financial disclosures at the time of publication.