In support of July 28th being World Hepatitis Day we would like to share with you British Columbia (BC) hepatitis C virus (HCV) disease burden estimates.
We have been working with Centre for Disease Analysis to adapt their HCV disease burden model for BC. The model uses a system dynamic framework and projects out the number of infections, decompensated cirrhosis, liver cancers, overall and liver related mortality over time.
The model is using input parameters specific to BC generated through BC Hepatitis Testers Cohort (BC-HTC) (http://bchtc.med.ubc.ca/). It incorporates treatment uptake and allows assessment of impact on disease burden by various HCV treatment scenarios. The model shows disease burden under the current treatment uptake scenario and what is needed to achieve the World Health Organizations (WHO) 2030 elimination targets (90% reduction in new chronic infections, 65% reduction in mortality). Through this tool, we hope to monitor how BC is doing towards reaching WHO HCV elimination goals and evaluate how our public health interventions could be optimized.
The BC model is accessible at following link: http://polarisobservatory.org/
In summary, treatment uptake in British Columbia has increased after introduction of direct acting antiviral agents. Uptake is expected to further increase next year with expanded coverage for HCV treatments. However, to achieve WHO elimination targets, there will be a need for treatment scale up, identification of undiagnosed people and a scale up of harm reduction/addiction and mental health services to prevent new infections and re-infections. We plan to update the model as more data become available. We will also validate that the model accurately measures the HCV disease burden in BC and creates a tool to monitor the effectiveness of our prevention, care and treatment programing.
Mel Krajden & Naveed Janjua
Mel Krajden, MD, FRCP(C)
Medical Director, BCCDC Public Health Laboratory
Medical Head, Hepatitis – Clinical Prevention ServicesBC Centre for Disease Control