Summary
Collaborators
Polaris Observatory HCV Collaborators: Sarah Blach, Stefan Zeuzem, Michael Manns, Ibrahim Altraif, Ann-Sofi Duberg, David H Muljono, Imam Waked, Seyed M Alavian, Mei-Hsuan Lee, Francesco Negro, Faisal Abaalkhail, Ahmed Abdou, Maheeba Abdulla, Antoine Abou Rached, Inka Aho, Ulus Akarca, Imad Al Ghazzawi, Saad Al Kaabi, Faryal Al Lawati, Khalid Al Namaani, Youssif Al Serkal, Said A Al-Busafi, Layla Al-Dabal, Soo Aleman, Abdullah S Alghamdi, Abdulrahman A Aljumah, Hamad E Al-Romaihi, Monique I Andersson, Vic Arendt, Perttu Arkkila, Abdullah M Assiri, Oidov Baatarkhuu, Abate Bane, Ziv Ben-Ari, Colm Bergin, Fernando Bessone, Florian Bihl, Abdul R Bizri, Martin Blachier, Antonio J Blasco, Carlos E Brandão Mello, Philip Bruggmann, Cheryl R Brunton, Filipe Calinas, Henry L Y Chan, Asad Chaudhry, Hugo Cheinquer, Chien-Jen Chen, Rong-Nan Chien, Moon Seok Choi, Peer B Christensen, Wan-Long Chuang, Vladimir Chulanov, Laura Cisneros, Mette R Clausen, Matthew E Cramp, Antonio Craxi, Esther A Croes, Olav Dalgard, Jorge R Daruich, Victor de Ledinghen, Gregory J Dore, Manal H El-Sayed, Gul Ergör, Gamal Esmat, Chris Estes, Karolin Falconer, Elmoubashar Farag, Maria L G Ferraz, Paulo R Ferreira, Robert Flisiak, Sona Frankova, Ivane Gamkrelidze, Ed Gane, Javier García-Samaniego, Amir Ghafoor Khan, Ilias Gountas, Adrian Goldis, Magnús Gottfredsson, Jason Grebely, Michael Gschwantler, Mário Guimarães Pessôa, Jessie Gunter, Behzad Hajarizadeh, Omer Hajelssedig, Saeed Hamid, Waseem Hamoudi, Angelos Hatzakis, Sayed M Himatt, Harald Hofer, Irena Hrstic, Yee-Tak Hui, Bela Hunyady, Ramazan Idilman, Wasim Jafri, Rohani Jahis, Naveed Z Janjua, Peter Jarčuška, Agita Jeruma, Jón G Jonasson, Yasser Kamel, Jia-Horng Kao, Sabahattin Kaymakoglu, David Kershenobich, Jawad Khamis, Young S Kim, Loreta Kondili, Zaher Koutoubi, Mel Krajden, Henrik Krarup, Moon-Sing Lai, Wim Laleman, Wai-Cheung Lao, Daniel Lavanchy, Pablo Lázaro, Henri Leleu, Olufunmilayo Lesi, Laurentius A Lesmana, Michael Li, Valentina Liakina, Young-Suk Lim, Boris Luksic, Adam Mahomed, Matti Maimets, Mihály Makara, Abraham O Malu, Rui T Marinho, Paul Marotta, Stefan Mauss, Muhammad S Memon, Maria C Mendes Correa, Nahum Mendez-Sanchez, Shahin Merat, Ammal M Metwally, Rosmawati Mohamed, Christophe Moreno, Fadi H Mourad, Beat Müllhaupt, Kimberly Murphy, Helen Nde, Richard Njouom, Diana Nonkovic, Suzanne Norris, Solomon Obekpa, Stephen Oguche, Sigurður Olafsson, Marian Oltman, Ogu Omede, Casimir Omuemu, Ohene Opare-Sem, Anne L H Øvrehus, Shirley Owusu-Ofori, Tsendsuren S Oyunsuren, George Papatheodoridis, Ken Pasini, Kevork M Peltekian, Richard O Phillips, Nikolay Pimenov, Hossein Poustchi, Nishi Prabdial-Sing, Huma Qureshi, Alnoor Ramji, Devin Razavi-Shearer, Kathryn Razavi-Shearer, Berhane Redae, Henk W Reesink, Ezequiel Ridruejo, Sarah Robbins, Lewis R Roberts, Stuart K Roberts, William M Rosenberg, Françoise Roudot-Thoraval, Stephen D Ryder, Rifaat Safadi, Olga Sagalova, Riina Salupere, Faisal M Sanai, Juan F Sanchez Avila, Vivek Saraswat, Rui Sarmento-Castro, Christoph Sarrazin, Jonathan D Schmelzer, Ivan Schréter, Carole Seguin-Devaux, Samir R Shah, Ala I Sharara, Manik Sharma, Anatoly Shevaldin, Gamal E Shiha, William Sievert, Mark Sonderup, Kyriakos Souliotis, Danute Speiciene, Jan Sperl, Peter Stärkel, Rudolf E Stauber, Catherine Stedman, Daniel Struck, Tung-Hung Su, Vana Sypsa, Soek-Siam Tan, Junko Tanaka, Alexander J Thompson, Ieva Tolmane, Krzysztof Tomasiewicz, Jonas Valantinas, Pierre Van Damme, Adriaan J van der Meer, Ingo van Thiel, Hans Van Vlierberghe, Adriana Vince, Wolfgang Vogel, Heiner Wedemeyer, Nina Weis, Vincent Ws Wong, Cesar Yaghi, Ayman Yosry, Man-Fung Yuen, Evy Yunihastuti, Aasim Yusuf, Eli Zuckerman, Homie Razavi
Background
The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of-and expansion on-the 2014 analysis, which reported 80 million (95% CI 64-103) viraemic infections in 2013.
Methods
We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data.
Findings
Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8-1·1) in 2015, corresponding to 71·1 million (62·5-79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively).
Interpretation
The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections.
Funding
John C Martin Foundation.