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Type: Artigo
Title: Disease burden of chronic hepatitis C in Brazil
Author: Ferreira, Paulo Roberto Abrão
Brandão-Mello, Carlos Eduardo
Estes, Chris
Gonçales Júnior, Fernando Lopes
Coelho, Henrique Sérgio Moraes
Razavi, Homie
Cheinquer, Hugo
Wolff, Fernando Herz
Ferraz, Maria Lúcia Gomes
Pessoa, Mário Guimarães
Mendes-Correa, Maria Cássia
Abstract: Hepatitis C virus infection is a major cause of cirrhosis; hepatocellular carcinoma; and liver transplantation. The aim of this study was to estimate hepatitis C virus disease progression and the burden of disease from a nationwide perspective. Using a model developed to forecast hepatitis C virus disease progression and the number of cases at each stage of liver disease; hepatitis C virus-infected population and associated disease progression in Brazil were quantified. The impact of two different strategies was compared: higher sustained virological response and treatment eligibility rates (1) or higher diagnosis and treatment rates associated with increased sustained virological response rates (2). The number of infected individuals is estimated to decline by 35% by 2030 (1,255,000 individuals); while the number of cases of compensated (n= 325,900) and decompen- sated (n = 45,000) cirrhosis; hepatocellular carcinoma (n = 19,100); and liver-related deaths (n = 16,700) is supposed to peak between 2028 and 2032. In strategy 2; treated cases increased over tenfold in 2020 (118,800 treated) as compared to 2013 (11,740 treated); with sustained virological response increased to 90% and treatment eligibility to 95%. Under this strategy; the number of infected individuals decreased by 90% between 2013 and 2030. Compared to the base case; liver-related deaths decreased by 70% by 2030; while hepatitis C virus-related liver cancer and decompensated cirrhosis decreased by 75 and 80%; respectively. While the incidence and prevalence of hepatitis C virus in Brazil are decreasing; cases of advanced liver disease continue to rise. Besides higher sustained virological response rates; new strategies focused on increasing the proportion of diagnosed patients and eligibility to treatment should be adopted in order to reduce the burden of hepatitis C virus infection in Brazil.
Subject: Epidemiologia
Hepatite C crônica
Country: Reino Unido
Editor: Elsevier
Rights: Aberto
Identifier DOI: 10.1016/j.bjid.2015.04.004
Date Issue: 2015
Appears in Collections:FCM - Artigos e Outros Documentos

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