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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17196

Title: The Disease Burden of Hepatitis C in Belgium : development of a realistic disease control strategy
Authors: Starkel, P.
VANDIJCK, Dominique
Laleman, W.
Van Damme, P.
Moreno, C.
Hindman, S.
Razavi, H.
Van Vlierberghe, H.
Issue Date: 2014
Citation: ACTA GASTRO-ENTEROLOGICA BELGICA, 77 (2), p. 280-284
Abstract: Background : Novel direct antiviral agents (DAAs) will become available soon with higher sustained viral response (SVR), fewer side-effects and higher compliance. Our aim was to evaluate different realistic strategies to control the projected increase in HCV-related disease burden in Belgium. Methods : Based on literature review, expert opinions and historical assumptions, HCV-disease progression and mortality in Belgium was modeled to 2030. Strategies exploring the impact of increased treatment, treatment delay, and treatment restrictions were developed. Results : Although the overall HCV prevalence is decreasing in Belgium, the burden of advanced stage HCV, including cirrhosis and hepatocellular carcinoma (HCC), is expected to increase under current treatment and cure rates. By increasing SVR to 90% from 2016 onward and the number of treated cases (from 710 to 2,050), in 2030 the cases with cirrhosis, decompensated cirrhosis and HCC would be significantly lower than in 2013. This strategy was found most efficient when applied to F2-F4 cases. To obtain comparable outcomes with F0-F4 cases, 3,490 patients should be treated. A two year delayed access to the DAAs increased HCV related morbidity and mortality by 15% relative to our strategy. Conclusions : Considering the evolving burden of HCV disease and the need for efficacious usage of healthcare resources, primary application of new DAAs in Belgium should focus on patients with significant and advanced fibrosis (F2-F4), providing these new drugs without delay upon availability and increasing access to therapy.
Notes: [Starkel, P.] Catholic Univ Louvain, Clin Univ St Luc, B-1200 Brussels, Belgium. [Vandijck, D.] Univ Ghent, B-9000 Ghent, Belgium. [Vandijck, D.] Hasselt Univ, Dept Hlth Econ & Patient Safety, Diepenbeek, Belgium. [Laleman, W.] Katholieke Univ Leuven, Univ Hosp, Leuven, Belgium. [Van Damme, P.] Univ Antwerp, B-2020 Antwerp, Belgium. [Moreno, C.] Univ Libre Brussels, Erasme Univ Hosp, Brussels, Belgium. [Hindman, S.; Razavi, H.] CDA, Louisville, KY USA. [Van Vlierberghe, H.] Ghent Univ Hosp, Ghent, Belgium.
URI: http://hdl.handle.net/1942/17196
ISI #: 000341234800017
ISSN: 0001-5644
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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