Theoretical impact of an anti-HCV vaccine on the annual number of liver transplantation.

The development of an effective vaccine for hepatitis C is of paramount importance, given the global disease burden and its public health impact. We simulated a theoretical vaccine with 98% efficacy and coverage of 95% of the susceptible population, an achievable program. The simulated period of vaccination varied from 0 to 70 years and we calculated, through a mathematical model, the reduction in the number of liver transplantations carried out each year. The program is entirely inefficient until 20 years of vaccination and its impact rises linearly with time, reaching a maximum of 40% reduction. The model assumes that approximately 50% of all the liver transplantation carried out in our population are due to HCV infection. Therefore, the maximum reduction in the number of transplantation attained after 70 years is 10% less of the theoretical optimum. This is due to the 2% of primary vaccination failure plus the 5% in the coverage failure, which leaves a small proportion of susceptible individuals who will catch the infection and evolve to liver failure. In conclusion, the advent of a hepatitis C vaccine is welcome however, decision makers should be prepared for a very long time living with this scourge.