Center for Disease Analysis, Lafayette, LA, USA.
Hôpital Henri Mondor, Université Paris-Est, and INSERM U955, Créteil, France.
Liver Int. 2021 Mar;41(3):456-463. doi: 10.1111/liv.14779. Epub 2021 Jan 19.
BACKGROUND & AIMS: Elimination of HCV by 2030, as defined by the World Health Organization (WHO), is attainable with the availability of highly efficacious therapies. This study reports progress made in the timing of HCV elimination in 45 high-income countries between 2017 and 2019.
Disease progression models of HCV infection for each country were updated with latest data on chronic HCV prevalence, and annual diagnosis and treatment levels, assumed to remain constant in the future. Modelled outcomes were analysed to determine the year in which each country would meet the WHO 2030 elimination targets.
Of the 45 countries studied, 11 (Australia, Canada, France, Germany, Iceland, Italy, Japan, Spain, Sweden, Switzerland, and United Kingdom) are on track to meet WHO's elimination targets by 2030; five (Austria, Malta, Netherlands, New Zealand, and South Korea) by 2040; and two (Saudi Arabia and Taiwan) by 2050. The remaining 27 countries are not expected to achieve elimination before 2050. Compared to progress in 2017, South Korea is no longer on track to eliminate HCV by 2030, three (Canada, Germany, and Sweden) are now on track, and most countries (30) saw no change.
Assuming high-income countries will maintain current levels of diagnosis and treatment, only 24% are on track to eliminate HCV by 2030, and 60% are off track by at least 20 years. If current levels of diagnosis and treatment continue falling, achieving WHO's 2030 targets will be more challenging. With less than ten years remaining, screening and treatment expansion is crucial to meet WHO's HCV elimination targets.
世界卫生组织（WHO）定义的到 2030 年消除 HCV 是可以实现的，这需要高效疗法的应用。本研究报告了在 2017 年至 2019 年间，45 个高收入国家在 HCV 消除时间方面取得的进展。
对每个国家的 HCV 感染疾病进展模型进行了更新，纳入了最新的慢性 HCV 流行率数据，以及未来假定保持不变的年度诊断和治疗水平。对模型结果进行分析，以确定每个国家将在哪一年达到 WHO 2030 年消除目标。
在所研究的 45 个国家中，有 11 个（澳大利亚、加拿大、法国、德国、冰岛、意大利、日本、西班牙、瑞典、瑞士和英国）有望在 2030 年达到 WHO 的消除目标；5 个（奥地利、马耳他、荷兰、新西兰和韩国）有望在 2040 年达到目标；2 个（沙特阿拉伯和中国台湾地区）有望在 2050 年达到目标。其余 27 个国家预计在 2050 年前无法实现消除。与 2017 年的进展相比，韩国不再有望在 2030 年消除 HCV，有 3 个（加拿大、德国和瑞典）现在有望实现，大多数国家（30 个）没有变化。
假设高收入国家将保持目前的诊断和治疗水平，只有 24%有望在 2030 年前消除 HCV，60%至少落后 20 年。如果目前的诊断和治疗水平继续下降，实现世卫组织的 2030 年目标将更加困难。距离实现目标仅剩不到十年时间，扩大筛查和治疗范围对于实现世卫组织的 HCV 消除目标至关重要。
