Eliminating viral hepatitis C in Belgium: the micro-elimination approach

Dana Busschots, Samira Toghanian, Rob Bielen, Stina Salomonsson, Ozguer M. Koc, Greet Hendrickx, Michel Jadoul, Frederik Nevens, Etienne Sokal, Christian Brixko, Kathelijne Peerlinck, Ludwig Apers, Geert Robaeys, Jeffrey V. Lazarus

Research output: Contribution to journalA1: Web of Science-article

Abstract

BackgroundHepatitis 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.MethodsWe 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.ResultsEleven 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.ConclusionsRemoving 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.

Original languageEnglish
Article number181
JournalBMC Infectious Diseases
Volume20
Issue number1
Number of pages12
ISSN1471-2334
DOIs
Publication statusPublished - 2020

Keywords

  • Disease elimination
  • Health policy
  • Hepatitis C
  • Treatment
  • Belgium
  • SOFOSBUVIR PLUS RIBAVIRIN
  • VIRUS HCV INFECTION
  • HIV-POSITIVE MSM
  • LIVER-DISEASE
  • INJECT DRUGS
  • PREEXPOSURE PROPHYLAXIS
  • TRANSMISSION
  • PEOPLE
  • BURDEN
  • HEMODIALYSIS

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