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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Hepatitis C virus infection in Argentina: Burden of chronic disease
Ezequiel Ridruejo, Fernando Bessone, Jorge R Daruich, Chris Estes, Adrián C Gadano, Homie Razavi, Federico G Villamil, Marcelo O Silva
Ezequiel Ridruejo, Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Ciudad Autónoma de Buenos Aires C1425ASG, Argentina
Ezequiel Ridruejo, Marcelo O Silva, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar 1629, Prov. de Buenos Aires, Argentina
Fernando Bessone, Hepatology Section, Escuela de Medicina, Universidad de Rosario, Rosario 2000, Prov. de Santa Fe, Argentina
Jorge R Daruich, Hepatology Section, Hospital de Clínicas San Martín, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires C1120AAF, Argentina
Chris Estes, Homie Razavi, Center for Disease Analysis, Louisville, CO 80026, Unired States
Adrián C Gadano, Hepatology and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires C1181ACH, Argentina
Federico G Villamil, Liver Transplantat Unit, Hospital Británico, Ciudad Autónoma de Buenos Aires C1280AEB, Argentina
Author contributions: Ridruejo E drafted the manuscript; Estes C and Razawi H participated in study design and performed statistical analysis; all authors were involved with data collection, assisted with data analysis, read and approved the final manuscript.
Institutional review board statement: None.
Informed consent statement: None.
Conflict-of-interest statement: Ridruejo E, Bessone F, Daruich JR, Gadano AC, Villamil FG and Silva MO have no conflicts of interest to declare; Estes C and Razavi H and are employees of the Center for Disease Analysis.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ezequiel Ridruejo, MD, Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Avda. Las Heras 2939, Ciudad Autónoma de Buenos Aires C1425ASG, Argentina.
eridruejo@gmail.com
Telephone: +54-11-52991221 Fax: +54-11-52990600
Received: January 28, 2016
Peer-review started: January 28, 2016
First decision: February 29, 2016
Revised: April 4, 2016
Accepted: May 10, 2016
Article in press: May 11, 2016
Published online: May 28, 2016
Processing time: 112 Days and 9.1 Hours
AIM: To estimate the progression of the hepatitis C virus (HCV) epidemic and measure the burden of HCV-related morbidity and mortality.
METHODS: Age- and gender-defined cohorts were used to follow the viremic population in Argentina and estimate HCV incidence, prevalence, hepatic complications, and mortality. The relative impact of two scenarios on HCV-related outcomes was assessed: (1) increased sustained virologic response (SVR); and (2) increased SVR and treatment.
RESULTS: Under scenario 1, SVR raised to 85%-95% in 2016. Compared to the base case scenario, there was a 0.3% reduction in prevalent cases and liver-related deaths by 2030. Given low treatment rates, cases of hepatocellular carcinoma and decompensated cirrhosis decreased < 1%, in contrast to the base case in 2030. Under scenario 2, the same increases in SVR were modeled, with gradual increases in the annual diagnosed and treated populations. This scenario decreased prevalent infections 45%, liver-related deaths 55%, liver cancer cases 60%, and decompensated cirrhosis 55%, as compared to the base case by 2030.
CONCLUSION: In Argentina, cases of end stage liver disease and liver-related deaths due to HCV are still growing, while its prevalence is decreasing. Increasing in SVR rates is not enough, and increasing in the number of patients diagnosed and candidates for treatment is needed to reduce the HCV disease burden. Based on this scenario, strategies to increase diagnosis and treatment uptake must be developed to reduce HCV burden in Argentina.
Core tip: This is a study evaluating potential policies to diminish hepatitis C virus (HCV) disease burden. Increasing diagnoses and treated individuals with the high current sustained virologic response rates, will diminish HCV disease burden.
