The road to elimination of Hepatitis C: Analysis of SVR versus new HCV infections in 91 countries

Transcription

1 tract #205 The road to elimination of Hepatitis C: Analysis of SVR versus new HCV infections in 91 countries Dr Andrew Hill, PhD, University of Liverpool, UK Sanjay Nath, Bryony Simmons MPH, Imperial College, London, UK

2 kground: WHO Targets O targets for elimination of Hepatitis C by 2030: 90% of people infected with HCV are diagnosed 80% of infected people are treated tabase: country-level rates of diagnosis, treatment in 2016 search question: are we on the road to elimination of HCV

3 hods: country-level database laris Observatory 2016: Total viraemic infections New HCV infections Numbers treated (assumed 90% SVR rate) Percentage of patients diagnosed, new diagnoses HCV related deaths (0.5% per year) Non-HCV related deaths (1.5% per year) For countries with missing data, regional averages were used.

4 hods: changes in prevalence ange in prevalence, : V infections in new HCV infections - cures - HCV-related deaths - non-hcv related deaths

5 hods: diagnosis and treatment HO targets

6 infections diagnosed by 2016 Foundation

7 ent new HCV diagnosis in 2016 oundation

8 diagnosis by Gross National Income WHO Target: 90% diagnosed High Income Upper-Middle Lower-middle Low income Countries Countries Countries Countries 44% 17% 15% 9% 3% 1.6% 1.3% 0.8% Foundation HIC UMIC LMIC LIC Income Group Diagnosis Rate 2016 New Diagnosis Rate 2016 Ref: Polaris databas

9 atients cured per new HCV infection: countries Foundation

10 ew HCV infections per patient cured: ountries Foundation

11 ges in HCV prevalence: Foundation

12 ges in HCV prevalence: Canada: -6% Russia: +4% USA: -9% Spain: -9% Egypt: -11% India: +1% China: -3% Japan: -13% Brazil: -4% Australia: -13% Foundation

13 ults: diagnostic burn-out Spain and Portugal could soon reach the stage where there are no more diagnosed patients availab t: stage, cure of HCV is limited by rates of new HCV diagnosis, which are currently low. ostic burn-out potential outcomes, based on 2016 data y HCV Diagnosed New HCV Cures Outcome Epidemic before 2016 Diagnoses in million 235,000 (13%) 10,000 (0.6%) 43,000 (2.4%) Dx Burn-out in , ,000 (43%) 5500 (1.7%) 25,000 (8%) Dx Burn-out in 202 al 96,000 37,000 (39%) 1300 (1.3%) 4400 (4.6%) Dx Burn-out in 202 Foundation

14 itations stimates of HCV prevalence and new infections are changing a ew data become available this analysis needs to be updated egularly. e cannot assume that current rates of diagnosis and treatment ill be maintained. Warehousing of patients may already have inished in some countries. Many patients could be diagnosed ith HCV, but unable to access or afford HCV DAAs.

15 clusions n 2016, there were 1.6 million people newly infected with HCV, versus 1 illion people cured. he worldwide HCV epidemic fell from 69.6 million in 2016 to 68.3 million n 2017 a reduction of only 2% his reduction is not large enough to achieve elimination of HCV by 2030 etween 6-7 million people need to be diagnosed and treated each year arm reduction needs to be intensified, to lower infection rates

16 es versus costs of HCV DAAs $160,000 $140,000 $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $142,710 $104,723 $96,404 $87,632 $84,281 $76,757 $68,280 $65,616 $50,059 $47,972 $37,729 $33,800 $29,361 $11,598 $9,906 $174 $0

17 real cost of HCV elimination F/DCV can now be produced for <$50 per 12-week treatment course $50 per course, it would cost $3.5 billion to treat all 70 million people cted with HCV worldwide bal sales of HCV DAAs from 1Q2014 to 2Q2017 average $1.6 billion r month. erefore, all 70 million people with HCV worldwide could be treate the equivalent of 10 weeks of commercial sales of the HCV DAA Gotham 2017, July 2017, International AIDS Society Conference, Paris, France