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Hepatitis C elimination in Sweden : Progress, challenges and opportunities for growth in the time of COVID-19

Blach, Sarah ; Blomé, Marianne LU ; Duberg, Ann Sofi ; Jerkeman, Anna LU ; Kåberg, Martin ; Klasa, Per Erik ; Lagging, Martin ; Razavi-Shearer, Devin ; Razavi, Homie and Aleman, Soo (2021) In Liver International 41(9). p.2024-2031
Abstract

Background & Aims: In 2014, the burden of hepatitis C virus (HCV) in Sweden was evaluated, to establish a baseline and inform public health interventions. Considering the changing landscape of HCV treatment, prevention, and care, and in light of the COVID-19 pandemic, this analysis seeks to evaluate Sweden's progress towards the World Health Organization (WHO) elimination targets and identify remaining barriers. Methods: The data used for modelling HCV transmission and disease burden in Sweden were obtained through literature review, unpublished sources and expert input. A dynamic Markov model was employed to forecast population sizes and incidence of HCV through 2030. Two scenarios (‘2019 Base’ and ‘WHO Targets’) were developed to... (More)

Background & Aims: In 2014, the burden of hepatitis C virus (HCV) in Sweden was evaluated, to establish a baseline and inform public health interventions. Considering the changing landscape of HCV treatment, prevention, and care, and in light of the COVID-19 pandemic, this analysis seeks to evaluate Sweden's progress towards the World Health Organization (WHO) elimination targets and identify remaining barriers. Methods: The data used for modelling HCV transmission and disease burden in Sweden were obtained through literature review, unpublished sources and expert input. A dynamic Markov model was employed to forecast population sizes and incidence of HCV through 2030. Two scenarios (‘2019 Base’ and ‘WHO Targets’) were developed to evaluate Sweden's progress towards HCV elimination. Results: At the beginning of 2019, there were 29 700 (95% uncertainty interval: 19 300-33 700) viremic infections in Sweden. Under the base scenario, Sweden would achieve and exceed the WHO targets for diagnosis, treatment and liver-related death. However, new infections would decrease by less than 10%, relative to 2015. Achieving all WHO targets by 2030 would require (i) expanding harm reduction programmes to reach more than 90% of people who inject drugs (PWID) and (ii) treating 90% of HCV + PWID engaged in harm reduction programmes and ≥7% of PWID not involved in harm reduction programmes, annually by 2025. Conclusions: It is of utmost importance that Sweden, and all countries, find sustainability in HCV programmes by broadening the setting and base of providers to provide stability and continuity of care during turbulent times.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COVID-19, elimination, hepatitis C virus, Sweden
in
Liver International
volume
41
issue
9
pages
2024 - 2031
publisher
Wiley-Blackwell
external identifiers
  • scopus:85108903498
  • pmid:34051065
ISSN
1478-3223
DOI
10.1111/liv.14978
language
English
LU publication?
yes
id
ae0e5d4c-9bad-4b1c-aff5-c8f9c1d7d028
date added to LUP
2021-08-13 13:54:06
date last changed
2024-06-29 15:22:54
@article{ae0e5d4c-9bad-4b1c-aff5-c8f9c1d7d028,
  abstract     = {{<p>Background &amp; Aims: In 2014, the burden of hepatitis C virus (HCV) in Sweden was evaluated, to establish a baseline and inform public health interventions. Considering the changing landscape of HCV treatment, prevention, and care, and in light of the COVID-19 pandemic, this analysis seeks to evaluate Sweden's progress towards the World Health Organization (WHO) elimination targets and identify remaining barriers. Methods: The data used for modelling HCV transmission and disease burden in Sweden were obtained through literature review, unpublished sources and expert input. A dynamic Markov model was employed to forecast population sizes and incidence of HCV through 2030. Two scenarios (‘2019 Base’ and ‘WHO Targets’) were developed to evaluate Sweden's progress towards HCV elimination. Results: At the beginning of 2019, there were 29 700 (95% uncertainty interval: 19 300-33 700) viremic infections in Sweden. Under the base scenario, Sweden would achieve and exceed the WHO targets for diagnosis, treatment and liver-related death. However, new infections would decrease by less than 10%, relative to 2015. Achieving all WHO targets by 2030 would require (i) expanding harm reduction programmes to reach more than 90% of people who inject drugs (PWID) and (ii) treating 90% of HCV + PWID engaged in harm reduction programmes and ≥7% of PWID not involved in harm reduction programmes, annually by 2025. Conclusions: It is of utmost importance that Sweden, and all countries, find sustainability in HCV programmes by broadening the setting and base of providers to provide stability and continuity of care during turbulent times.</p>}},
  author       = {{Blach, Sarah and Blomé, Marianne and Duberg, Ann Sofi and Jerkeman, Anna and Kåberg, Martin and Klasa, Per Erik and Lagging, Martin and Razavi-Shearer, Devin and Razavi, Homie and Aleman, Soo}},
  issn         = {{1478-3223}},
  keywords     = {{COVID-19; elimination; hepatitis C virus; Sweden}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2024--2031}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Liver International}},
  title        = {{Hepatitis C elimination in Sweden : Progress, challenges and opportunities for growth in the time of COVID-19}},
  url          = {{http://dx.doi.org/10.1111/liv.14978}},
  doi          = {{10.1111/liv.14978}},
  volume       = {{41}},
  year         = {{2021}},
}