Disease burden of chronic hepatitis C in Brazil

Braz J Infect Dis. Jul-Aug 2015;19(4):363-8. doi: 10.1016/j.bjid.2015.04.004. Epub 2015 Jun 4.

Abstract

Background: 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.

Methods: 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).

Results: 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 decompensated (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.

Conclusions: 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.

Keywords: Brazil; Disease burden; Epidemiology; HCV; Incidence.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents
  • Brazil / epidemiology
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / virology*
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / epidemiology
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / virology*
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / virology*
  • Liver Transplantation
  • Male
  • Middle Aged
  • Models, Theoretical
  • Prevalence
  • Risk Factors
  • Young Adult

Substances

  • Antiviral Agents