Hepatitis C virus infection in Argentina: Burden of chronic disease

作     者：Ezequiel Ridruejo Fernando Bessone Jorge R Daruich Chris Estes Adrián C Gadano Homie Razavi Federico G Villamil Marcelo O Silva 

作者机构：Hepatology Section Department of Medicine Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno Hepatology and Liver Transplant Unit Hospital Universitario Austral Hepatology Section Escuela de Medicina Universidad de Rosario Hepatology Section Hospital de Clínicas San Martín Universidad de Buenos Aires Center for Disease Analysis Louisville Hepatology and Liver Transplant Unit Hospital Italiano de Buenos Aires Liver Transplantat Unit Hospital Británico 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第15期

页      面：649-658页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Diagnosis Disease burden Epidemiology Incidence Mortality Prevalence Treatment Argentina Hepatitis C 

摘      要：AIM: To estimate the progression of the hepatitis C virus(HCV) epidemic and measure the burden of HCVrelated morbidity and mortality. METHODS: Age- and gender-defined cohorts were used to follow the viremic population in Argentina and estimate HCV incidence, prevalence, hepatic complications, and mortality. The relative impact of two scenarios on HCV-related outcomes was assessed:(1) increased sustained virologic response(SVR); and(2) increased SVR and ***: Under scenario 1, SVR raised to 85%-95% in 2016. Compared to the base case scenario, there was a 0.3% reduction in prevalent cases and liverrelated deaths by 2030. Given low treatment rates, cases of hepatocellular carcinoma and decompensated cirrhosis decreased 1%, in contrast to the base case in 2030. Under scenario 2, the same increases in SVR were modeled, with gradual increases in the annual diagnosed and treated populations. This scenario decreased prevalent infections 45%, liver-related deaths 55%, liver cancer cases 60%, and decompensated cirrhosis 55%, as compared to the base case by 2030. CONCLUSION: In Argentina, cases of end stage liver disease and liver-related deaths due to HCV are still growing, while its prevalence is decreasing. Increasing in SVR rates is not enough, and increasing in the number of patients diagnosed and candidates for treatment is needed to reduce the HCV disease burden. Based on this scenario, strategies to increase diagnosis and treatment uptake must be developed to reduce HCV burden in Argentina.