Cent Eur J Public Health 2019, 27(2):93-98 | DOI: 10.21101/cejph.a5350

Chronic hepatitis C in the Czech Republic: Forecasting the disease burden

Soňa Fraňková1, Petr Urbánek2, Petr Husa3, Vratislav Němeček4, Homie Razavi5, Devin Razavi-Shearer5, Roman Chlíbek6, Jan ©perl1
1 Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
2 Department of Internal Medicine, First Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic
3 Clinic of Infectious Diseases, University Hospital Brno, Masaryk University, Brno, Czech Republic
4 National Reference Laboratory for Hepatitis, National Institute of Public Health, Prague, Czech Republic
5 Center for Disease Analysis, Lafayette, Colorado, USA
6 Department of Epidemiology, Vaccination Centre, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic

Objective: Chronic HCV infection is associated with cirrhosis of the liver, hepatocellular carcinoma (HCC), and liver transplantation. HCV disease burden and the impact of new potent direct acting antivirals (DAAs) in the Czech Republic are unknown.

Methods: Using a modelling framework, HCV disease progression in the Czech Republic was predicted to 2030 under the current standard of care treatment structure. In addition, two strategies to reduce the future burden of HCV infection were modelled: an incremental increase in treatment annually and WHO targets.

Results: The number of viremic infected individuals in the Czech Republic is estimated to peak in 2026 (n = 55,130) and to decline by 0.5% by 2030 (n = 54,840). The number of individuals with compensated cirrhosis (n = 1,400), decompensated cirrhosis (n = 80), HCC (n = 70), and liver-related deaths (n = 60) is estimated to more than double by 2030. Through aggressive increases in diagnosis and treatment, HCV related mortality may decrease by 70% by 2030.

Conclusions: Disease burden associated with chronic HCV infection is projected to peak in the Czech Republic in 30-40 years. Assuming that the current portion of DAAs used remains constant, a significant reduction in HCV disease burden is possible through increased diagnosis and treatment through 2030. This analysis provides evidence in order to facilitate the development of national strategies for HCV care and management in the Czech Republic.

Keywords: hepatitis C, disease burden, epidemiology, Czech Republic

Received: March 25, 2018; Revised: April 25, 2019; Accepted: April 25, 2019; Published: June 26, 2019  Show citation

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Fraňková S, Urbánek P, Husa P, Němeček V, Razavi H, Razavi-Shearer D, et al.. Chronic hepatitis C in the Czech Republic: Forecasting the disease burden. Cent Eur J Public Health. 2019;27(2):93-98. doi: 10.21101/cejph.a5350. PubMed PMID: 31241282.
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