What would it take to completely eliminate hepatitis C virus (HCV) infection in one state of the United States by the year 2030? Researchers from Brown University set out to answer this question by taking a deep look at hepatitis C in the state of Rhode Island.
Currently, Rhode Island restricts treatment to patients with at least stage 3 fibrosis. The researchers ran projections of various scenarios, such as doubling annual treatment numbers and including patients with at least stage 2 fibrosis. Then, the researchers projected an “elimination scenario” in which treatment of HCV-infected Rhode Islanders was increased to 2,000 treated per year by 2020. This change would decrease the number of infections in the state by 90%. As a quality-of-life side benefit, doing this would also prevent at least 70% of liver-related fatalities by the year 2030.
Essentially, this increased treatment access would nearly eliminate HCV from one state by 2030. This opportunity is available due to the high effectiveness rate of current HCV treatments. Approximately one in every 30 Baby Boomers in the U.S. is infected with hepatitis C (with many of them not knowing their disease status), but treatment can cure this infection in just a matter of weeks.
Although the initial costs needed to invest in widespread treatment would be considerable, this price tag would be offset by the prevention of the expensive-to-treat cases of cirrhosis, liver failure, and liver cancer that would simply never occur in the cured patients.
Soipe AI, Razavi H, Razavi-Shearer D, et al. Chronic hepatitis C virus (HCV) burden in Rhode Island: modeling treatment scale-up and elimination. Epidem Inf 2016;1: 10.1017/S0950268816001722.