Disease Burden of Hepatitis C in the Austrian state of Tyrol – Epidemiological Data and Model Analysis to achieve Elimination by 2030

Background:

In 2016 the World Health Organization (WHO) and 69th World Health Assembly approved the first global health sector strategy (GHSS) on viral hepatitis with the goal to eliminate hepatitis C virus (HCV) infections worldwide. The aim is a 90% reduction of new infections and 65% reduction of HCV-related deaths by 2030.

Aim:

This study reports on the epidemiology of HCV infections in the Austrian state of Tyrol (total population 750,000) and uses a predictive model to identify how the WHO strategy for elimination of HCV can be achieved.

Methods:

We developed a regional disease burden models based on observed local diagnosis data from 2001 to 2016. Scenarios were developed to evaluate the impact of prevention, diagnosis and treatment on HCV-related outcomes (viremic prevalence, decompensated cirrhosis, hepatocellular carcinoma, and liver-related deaths) from 2017 through 2030.

Results:

In the last 15 years 1721 patients living in Tyrol have been diagnosed with chronic HCV infection. When ageing, mortality and treatment was factored in, there were an estimated 1136 total diagnosed, viremic cases in 2015 whereas 2043 cases are expected based on published prevalence data. A baseline model predicts a decrease of 588 HCV cases from 2015 to 2030 which would not translate into a significant reduction of new infections needed to achieve WHO global health recommendations. A total of 1843 infected individuals need to be identified and treated to achieve the WHO goals by 2030 (1254 averted cases as compared to baseline model). Implementation of this strategy would avoid 523 new HCV infections and decreases HCV-related mortality by 73%.