Examining HCV Burden in EU and Measures to Eradicate it by 2030

In May 2016, the World Health Assembly, the division of the World Health Organization (WHO) responsible for decision-making, developed a strategy with the ultimate goal of eliminating viral hepatitis worldwide by the year 2030. The concrete goals were set forth to reduce viral hepatitis infections by 90% as well as to reduce the mortality associated with viral hepatitis by 65% in the next 13 years. Although WHO set specific goals in hopes of eliminating HCV, the exact measures that need to be taken to achieve this goal have yet to be determined.

The hepatitis C virus (HCV), a small enveloped RNA virus, is the causative agent of the significant disease burden associated with hepatitis C infection. Worldwide, HCV chronically affects between 130 to 150 million people. Many of these HCV-positive individuals will develop serious liver complications such as cirrhosis or hepatocellular carcinoma, and every year approximately 700,000 individuals die due to HCV-related complications.

A modeling study conducted by Homie Razavi, PhD, MBA, from the Center for Disease Analysis, and published in Lancet Gastroenterology and Hepatology, sought to determine the HCV burden in the European Union (EU) as well as the measures that are needed for WHO to eradicate HCV in the European Union by the year 2030.

Dr. Razavi and his colleagues began by conducting an exhaustive, country-specific literature search and then confirmed the data with experts in 27 countries belonging to the EU. The data was utilized to create an EU disease model that can be used to predict HCV prevalence as well as morbidity and mortality associated with the disease. In addition, the authors took into consideration the wave of immigration into the EU in the past few years, predominately from Syria, Iraq, and Afghanistan.

The authors determined that, in order to reach the goal set forth by the World Health Assembly, if 95% of patients achieve a sustained viral response (SVR), then HCV treatment with Direct-Acting antivirals in the EU needs to increase from 150,000 patients in 2015 to 187,000 patients by 2025. In addition, treatment needs to expand to patients in all stages of fibrosis as well as in all age groups from 15-74 years of age beginning in 2017. Diagnosis of new cases needs to go up from 88,800 new cases every year to 180,000 newly diagnosed cases by 2025. Dr. Razavi’s model predicts that if these measures are taken, the number of individuals with liver cirrhosis resulting from HCV would decline by 60%. Likewise, the number of individuals with liver cancer as a result of their HCV infection would be reduced by 70%.

This study represents the work of more than 100 experts from 27 countries and is the most all-encompassing study to examine the prevalence and burden of HCV in the EU. The results of the study demonstrated that HCV prevalence is not uniform across the EU, with 9 out of the 27 countries examined shouldering more than 80% of the total HCV burden in the region.

However, with increased diagnosis and screening efforts, Dr. Razavi and his colleagues indicate that the EU is tactically poised to eliminate viral hepatitis and meet WHO’s HCV eradication goals by 2030.

Samar Mahmoud graduated from Drew University in 2011 with a BA in Biochemistry and Molecular Biology. After two years of working in industry as a Quality Control Technician for a blood bank, she went back to school and graduated from Montclair State University in 2016 with an MS in Pharmaceutical Biochemistry. She is currently pursuing her PhD in Molecular and Cellular Biology at the University of Massachusetts at Amherst.