Hepatitis C: It's possible to avoid 15 million new infections by 2030

A new study from Imperial College London recommends combining prevention, screening and routine treatment of hepatitis C to prevent 15 million new infections and 1.5 million deaths by 2030.

Often silent and asymptomatic, hepatitis C is a viral infection of the liver that is transmitted through the blood and may eventually cause cirrhosis and primary cancer of the liver.

If antiviral treatments developed since 2014 can cure more than 90% of cases, hepatitis C continues to wreak havoc around the world. Globally, it is estimated that 71 million people are chronically infected with the hepatitis C virus and that 10 to 20% of them will develop liver complications, including cirrhosis and cancer, which caused more than 475,000 deaths in 2015. In recent years, the number of deaths from viral hepatitis has increased. The most affected countries are China, India and Pakistan.

Yet, many infections and deaths are preventable. In a new study published in The LancetResearchers at Imperial College London argue that by combining prevention, screening and treatment, 15 million new infections and 1.5 million preventable deaths will be prevented by 2030.

A global strategy to fight hepatitis C

This possible progress is in line with the World Health Organization (WHO) targets to reduce the number of new hepatitis C infections by 80% and 60% of deaths from 2015. The goal of mortality, set at 65% by the WHO, would be achieved by 2032 predict the authors of the study. "Even if the WHO's 2030 goals are far from being achieved, the impact of our estimates suggests a huge step forward," said Professor Alastair Heffernan of Imperial College London.

"The elimination of the hepatitis C virus is an extremely ambitious goal that requires improved prevention interventions and screening, especially in the most affected countries, such as China, India and Pakistan. these options are well below the levels we consider necessary to have a major impact on the epidemic, and research on how to improve it in all contexts, as well as increased funding, will be needed if we want to achieve these goals. "

To determine what public health measures can reduce hepatitis C infections and deaths, researchers created a model of the global hepatitis C epidemic in 190 countries using demographics and consumer data. injecting drug use, current treatment and prevention programs, historical trends, prevalence and mortality rates. They then estimated the effects of four interventions: first, the implementation of comprehensive measures for blood safety and infection control, the expansion of harm reduction services (such as opioid substitution therapy and needle and syringe programs) for injecting drug users, the provision of treatment to all persons as soon as they are diagnosed with hepatitis C infection, and the extension of screening, 90% of people with hepatitis C are diagnosed and treated by 2030.

An estimated cost of several tens of billions of dollars

But for the authors of the study, such a strategy requires states to invest financially, to the tune of "tens of billions of dollars by 2030". WHO has estimated the cost of implementing its strategy at $ 11.9 billion for the period 2016-2021, note the authors of the study. "The identification of these resources will be particularly difficult in this period of reduced investment in global health and refocusing on universal health coverage rather than disease-specific programs," say the researchers, who point out the efforts made at the global level by States.

For example, in 2016, WHO's 194 Member States committed to eliminating viral hepatitis as a threat to public health. These goals include reducing mortality by 65% ​​and 80% of new infections by 2030, compared to 2015 rates. "To achieve this, transmission must be prevented (by improving blood safety and infection control, expand harm reduction services for injecting drug users), expanding testing and increasing direct-acting antiviral (DAA) treatment for those already infected, "the scientists note.