Faculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.
BMC Infect Dis. 2020 Feb 27;20(1):181. doi: 10.1186/s12879-020-4898-y.
Hepatitis C virus is one of the leading causes of chronic liver disease and liver-related deaths worldwide. The estimated prevalence of chronic hepatitis C viral infection among the general Belgian population was 0.57% (n = 64,000) in 2015. Although Belgium has had a 'Hepatitis C Plan' since 2014, elimination efforts are unclear. This study employs the best available data and modelling estimates to define the burden of hepatitis C viral infection among key subgroups in Belgium, identify information gaps and propose potential approaches to screening, linkage to care and treatment, and cure.
We examined the peer-reviewed and grey literature since 2012 for data on the prevalence of hepatitis C viral infection in Belgium in key subgroups identified by national experts and in the literature. Ultimately, this research is primarily based on data provided by the key stakeholders themselves due to a lack of reliable data in the literature. Based on this, we modelled the treatment rates required to reach elimination of hepatitis C in several subgroups.
Eleven potential subgroups were identified. There were no data available for two subgroups: generational cohorts and men who have sex with men. In six subgroups, fewer than 3000 people were reported or estimated to have hepatitis C infection. Migrants and people who inject drugs were the most affected subgroups, and children were the least affected subgroup. Only two subgroups are on target to achieve elimination by 2030: patients living with haemophilia and transplant recipients.
Removing Belgian treatment reimbursement restrictions in January 2019 was a big step towards eliminating HCV. In addition, increasing surveillance, including with a national registry, treatment prescription by other health-care providers and availability of treatment in local pharmacies are central to improving the current situation and getting on track to reach the 2030 WHO hepatitis C elimination targets in Belgium.
丙型肝炎病毒是全球导致慢性肝病和与肝脏相关死亡的主要原因之一。2015 年，比利时普通人群中慢性丙型肝炎病毒感染的估计患病率为 0.57%（n=64000）。尽管比利时自 2014 年以来就有“丙型肝炎计划”，但其消除努力尚不清楚。本研究利用最佳现有数据和建模估计值，确定了比利时关键亚组丙型肝炎病毒感染的负担，确定了信息差距，并提出了潜在的筛查、与护理和治疗的联系以及治愈方法。
我们自 2012 年以来，查阅了同行评议文献和灰色文献，以获取有关比利时国家专家确定的关键亚组和文献中丙型肝炎病毒感染流行率的数据。最终，由于文献中缺乏可靠的数据，本研究主要基于主要利益攸关方自己提供的数据。在此基础上，我们对达到几个亚组消除丙型肝炎所需的治疗率进行了建模。
确定了十一个潜在的亚组。有两个亚组没有数据：代际队列和男男性行为者。在六个亚组中，报告或估计有丙型肝炎感染的人数少于 3000 人。移民和吸毒者是受影响最严重的亚组，儿童是受影响最小的亚组。只有两个亚组有望在 2030 年达到消除目标：血友病患者和移植受者。
2019 年 1 月取消比利时治疗报销限制是消除丙型肝炎的重要一步。此外，加强监测，包括建立国家登记册、其他卫生保健提供者开具治疗处方以及在当地药店提供治疗，是改善现状并使比利时走上 2030 年达到世界卫生组织丙型肝炎消除目标的关键。
