Effects and Costs of Hepatitis C Virus Elimination for the Whole Population in China: A Modelling Study.

Background and Objective: China has the highest number of hepatitis C virus (HCV) infections in the world. However, it is unclear what levels of screening and treatment are needed to achieve the WHO 2030 hepatitis C elimination targets. We aimed to evaluate the impact of scaling up interventions on the hepatitis C epidemic and determine how and at what cost these elimination targets could be achieved for the whole population in China.
Methods: We developed a compartmental model incorporating HCV transmission, disease progression, and care cascade for the whole population in China, calibrated with data on demographics, injecting drug use, HCV prevalence, and treatments. Five different scenarios were evaluated for effects and costs for 2022-2030. All costs were converted to 2021 US dollar (USD) and discounted at an annual rate of 5%. One-way sensitivity analyses were conducted to assess the robustness of the model.
Results: Under the status quo scenario, the incidence of hepatitis C is projected to increase from 60.39 (57.60-63.45) per 100,000 person-years in 2022 to 68.72 (65.3-73.97) per 100,000 person-years in 2030, and 2.52 million (1.94-3.07 million) infected patients are projected to die between 2022 and 2030, of which 0.76 (0.61-1.08) million will die due to hepatitis C. By increasing primary screening to 10%, conducting regular rescreening (annually for PWID and every 5 years for the general population) and treating 90% of patients diagnosed, the incidence would be reduced by 88.15% (86.61-89.45%) and hepatitis C-related mortality by 60.5% (52.62-65.54%) by 2030, compared with 2015 levels. This strategy would cost USD 52.78 (USD 43.93-58.53) billion.
Conclusions: Without changes in HCV prevention and control policy, the disease burden of HCV in China will increase dramatically. To achieve the hepatitis C elimination targets, China needs to sufficiently scale up screening and treatment.
Competing Interests: Declarations Competing Interests The authors declare that they have no competing interests. Funding National Natural Science Foundation of China (grant number 71874209), the research project of the Health Commission of Hunan province (grant number 202113050283), the Fundamental Research Funds for the Central Universities of Central South University (grant number 2023ZZTS0924), and Hunan Provincial Natural Science Foundation of China (grant number 2023JJ60503). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Patient and Public Involvement Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research. Patient Consent for Publication Not applicable. Ethics Approval Not applicable. Data Availability Statement All data relevant to the study are included in the article or uploaded as online supplemental information. Code Availability The code associated with this study is proprietary. Author Contributions M.W., J.M., S.L., and X.W. developed the model and performed the analyses and interpreted the results. M.W., S.Q., O.X., and A.n.L. collected data and drafted the manuscript. A.L. and X.W. contributed to the conception and design of the primary model. M.W., C.T., and X.W. had access to and verified the data. M.W., A.L., and X.W. were responsible for the decision to submit the manuscript. All authors have read and approved the final article.
(© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)