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Forecasted impacts of a sofosbuvir-based national hepatitis C treatment programme on Egypt's hepatocellular cancer epidemic: simulation of alternatives.
Ma, Wenkang; Soliman, Amr S; Anwar, Wagida A; Hablas, Ahmed; El Din, Tamer B; Ramadan, Mohamed; Seifeldin, Ibrahim A; Wilson, Mark L.
Afiliación
  • Ma W; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
  • Soliman AS; Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, USA.
  • Anwar WA; Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
  • Hablas A; Gharbiah Cancer Registry and Tanta Cancer Center, Tanta, Egypt.
  • El Din TB; HEOR, Cairo, Egypt.
  • Ramadan M; Gharbiah Cancer Registry and Tanta Cancer Center, Tanta, Egypt.
  • Seifeldin IA; Gharbiah Cancer Registry and Tanta Cancer Center, Tanta, Egypt.
  • Wilson ML; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
BMJ Glob Health ; 3(2): e000572, 2018.
Article en En | MEDLINE | ID: mdl-29707244
BACKGROUND: Egypt is experiencing a hepatocellular cancer (HCC) epidemic due to widespread hepatitis C virus (HCV) transmission. The use of sofosbuvir-related therapies producing improved treatment success has permitted an updated, nationwide, HCV treatment programme with expanded coverage. This study simulated the multidecade impacts of the new treatment programme on hepatitis and HCC. METHODS: A Markov model of HCV infection and treatment analysed the HCV-related HCC epidemic between 2009 and 2050, using parameters based on peer-reviewed studies and expert opinion. Comparing the 'new' and 'old' scenarios, and with the old treatment programme being replaced or not by the new programme in 2015, the annual number, prevalence and incidence of HCC were simulated for representative Egypt populations including HCV-infected patients aged 15-59 years in 2008, healthy people aged 5-59 years in 2008 and 5-year-old children cohorts entering the population each year beginning in 2009. Averted HCC cases were calculated, and sensitivity analyses were performed. RESULTS: Compared with the old scenario, the estimated number, prevalence and incidence of future HCC cases in the new scenario would peak earlier and at lower levels in 2025 (~29 000), 2023 (~28/100 000) and 2022 (~14/100 000), respectively. The new treatment programme is estimated to avert ~956 000 HCC cases between 2015 and 2050. DISCUSSION: By reducing cancer cases and shortening the peak epidemic period, the new programme should substantially diminish the HCC epidemic across Egypt. Our timeline forecast for Egypt's HCC epidemic, and evaluation of various disease and programme components, should be useful to other countries that are developing policies to address HCV-related liver cancer prevention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: BMJ Glob Health Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: BMJ Glob Health Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido