The Disease Burden of Chronic Hepatitis C in Turkey
Methods: Using a modeling approach, we quantified the HCV-infected population and associated disease progression through 2030. The HCV-infested population was characterized using published literature, Turkish government reports including year-end 2013 and estimates from a panel of country experts. We developed three treatment strategies to analyze the changes in burden of HCV infection: treatment of patients >F3 with new DAAs (restricted treatment), treatment of all patients with new DAAs (unrestricted treatment) and increased diagnosis and treatment for the elimination of HCV.
The viremic prevalence is estimated to have peaked in 1998 (601,000 individuals), and to decline 40.2% by 2030 (359,000 cases). However, the number of cases of compensated (n=74,500) and decompensated (n=9.480) cirrhosis, HCC (n=4,170), and liver-related deaths (n=3,670) will peak between 2028-2032.
Compared to the base case, under restricted treatment HCV related mortality will decrease 7% by 2030. Under unrestricted treatment, HCV related mortality will decrease 22% by 2030. Elimination was achieved through aggressive treatment and diagnosis wherein mortality was decreased by 77%.
Prevalence of HCV infection in Turkey has been declining for the last 15 years; however, the prevalence of HCV-related liver disease, morbidity and mortality is increasing. This analysis may facilitate the development of strategies for HCV care and management in Turkey.
R. Idilman, None