Australia needs to increase testing to achieve hepatitis C elimination
Objectives To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct‐acting antiviral (DAA) treatments. Design Analysis of quarterly data on government‐subsidised hepatitis C RNA testing and hepatitis C treatment i...
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Veröffentlicht in: | Medical journal of Australia 2020-05, Vol.212 (8), p.365-370 |
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creator | Scott, Nick Sacks‐Davis, Rachel Wade, Amanda J Stoove, Mark Pedrana, Alisa Doyle, Joseph S Thompson, Alexander J Wilson, David P Hellard, Margaret E |
description | Objectives
To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct‐acting antiviral (DAA) treatments.
Design
Analysis of quarterly data on government‐subsidised hepatitis C RNA testing and hepatitis C treatment in Australia, January 2013 – June 2018. Changes in testing and treatment levels associated with DAA availability were assessed in an autoregressive integrated moving average (ARIMA) statistical model, and the impact by 2030 of different levels of testing and treatment were estimated using a mathematical model.
Major outcome measures
Hepatitis C prevalence among people who inject drugs; annual hepatitis C incidence relative to 2015 levels; projections for the hepatitis C care cascade in 2030.
Results
The mean annual number of treatments initiated for people with hepatitis C increased from 6747 during 2013–2015 (before the introduction of DAAs) to 28 022 during 2016–18; the mean annual number of diagnostic RNA tests increased from 17 385 to 23 819. If current trends in testing and treatment continue (ie, 2018 testing numbers are maintained but treatment numbers decline by 50%), it is projected that by 2030 only 72% of infected people would be treated (by 2025 all people diagnosed with hepatitis C would be treated). The incidence of hepatitis C in 2030 would be 59% lower than in 2015, well short of the WHO target of an 80% reduction. The identification and testing of people exposed to hepatitis C must be increased by at least 50% for Australia to reach the WHO elimination targets.
Conclusion
Hepatitis C elimination programs in Australia should focus on increasing testing rates and linkage with care to maintain adequate levels of treatment. |
doi_str_mv | 10.5694/mja2.50544 |
format | Article |
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To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct‐acting antiviral (DAA) treatments.
Design
Analysis of quarterly data on government‐subsidised hepatitis C RNA testing and hepatitis C treatment in Australia, January 2013 – June 2018. Changes in testing and treatment levels associated with DAA availability were assessed in an autoregressive integrated moving average (ARIMA) statistical model, and the impact by 2030 of different levels of testing and treatment were estimated using a mathematical model.
Major outcome measures
Hepatitis C prevalence among people who inject drugs; annual hepatitis C incidence relative to 2015 levels; projections for the hepatitis C care cascade in 2030.
Results
The mean annual number of treatments initiated for people with hepatitis C increased from 6747 during 2013–2015 (before the introduction of DAAs) to 28 022 during 2016–18; the mean annual number of diagnostic RNA tests increased from 17 385 to 23 819. If current trends in testing and treatment continue (ie, 2018 testing numbers are maintained but treatment numbers decline by 50%), it is projected that by 2030 only 72% of infected people would be treated (by 2025 all people diagnosed with hepatitis C would be treated). The incidence of hepatitis C in 2030 would be 59% lower than in 2015, well short of the WHO target of an 80% reduction. The identification and testing of people exposed to hepatitis C must be increased by at least 50% for Australia to reach the WHO elimination targets.
Conclusion
Hepatitis C elimination programs in Australia should focus on increasing testing rates and linkage with care to maintain adequate levels of treatment.</description><identifier>ISSN: 0025-729X</identifier><identifier>EISSN: 1326-5377</identifier><identifier>DOI: 10.5694/mja2.50544</identifier><identifier>PMID: 32167586</identifier><language>eng</language><publisher>Australia: John Wiley and Sons Inc</publisher><subject>Epidemiology ; Hepatitis, viral ; Infectious Diseases ; Research and Reviews ; Statistics, Epidemiology and Research Design</subject><ispartof>Medical journal of Australia, 2020-05, Vol.212 (8), p.365-370</ispartof><rights>2020 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd</rights><rights>2020 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4204-51fe5ba3ca9683d56f5de61401f8a7a86c654311ee7332cb4967c92ee2651423</citedby><cites>FETCH-LOGICAL-c4204-51fe5ba3ca9683d56f5de61401f8a7a86c654311ee7332cb4967c92ee2651423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.5694%2Fmja2.50544$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.5694%2Fmja2.50544$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32167586$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scott, Nick</creatorcontrib><creatorcontrib>Sacks‐Davis, Rachel</creatorcontrib><creatorcontrib>Wade, Amanda J</creatorcontrib><creatorcontrib>Stoove, Mark</creatorcontrib><creatorcontrib>Pedrana, Alisa</creatorcontrib><creatorcontrib>Doyle, Joseph S</creatorcontrib><creatorcontrib>Thompson, Alexander J</creatorcontrib><creatorcontrib>Wilson, David P</creatorcontrib><creatorcontrib>Hellard, Margaret E</creatorcontrib><title>Australia needs to increase testing to achieve hepatitis C elimination</title><title>Medical journal of Australia</title><addtitle>Med J Aust</addtitle><description>Objectives
To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct‐acting antiviral (DAA) treatments.
Design
Analysis of quarterly data on government‐subsidised hepatitis C RNA testing and hepatitis C treatment in Australia, January 2013 – June 2018. Changes in testing and treatment levels associated with DAA availability were assessed in an autoregressive integrated moving average (ARIMA) statistical model, and the impact by 2030 of different levels of testing and treatment were estimated using a mathematical model.
Major outcome measures
Hepatitis C prevalence among people who inject drugs; annual hepatitis C incidence relative to 2015 levels; projections for the hepatitis C care cascade in 2030.
Results
The mean annual number of treatments initiated for people with hepatitis C increased from 6747 during 2013–2015 (before the introduction of DAAs) to 28 022 during 2016–18; the mean annual number of diagnostic RNA tests increased from 17 385 to 23 819. If current trends in testing and treatment continue (ie, 2018 testing numbers are maintained but treatment numbers decline by 50%), it is projected that by 2030 only 72% of infected people would be treated (by 2025 all people diagnosed with hepatitis C would be treated). The incidence of hepatitis C in 2030 would be 59% lower than in 2015, well short of the WHO target of an 80% reduction. The identification and testing of people exposed to hepatitis C must be increased by at least 50% for Australia to reach the WHO elimination targets.
Conclusion
Hepatitis C elimination programs in Australia should focus on increasing testing rates and linkage with care to maintain adequate levels of treatment.</description><subject>Epidemiology</subject><subject>Hepatitis, viral</subject><subject>Infectious Diseases</subject><subject>Research and Reviews</subject><subject>Statistics, Epidemiology and Research Design</subject><issn>0025-729X</issn><issn>1326-5377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp9kE1Lw0AQhhdRbK1e_AGSowip2e_kIpRi_aDipQdvy3Yzabfko2aTSv-9G1NFL56W2Xl4Z-ZB6BJHYy4SdltsNBnziDN2hIaYEhFyKuUxGkYR4aEkydsAnTm38SXmRJ6iASVYSB6LIZpNWtfUOrc6KAFSFzRVYEtTg3YQNOAaW666P23WFnYQrGGrG9tYF0wDyG1hS19W5Tk6yXTu4OLwjtBidr-YPobz14en6WQeGkYiFnKcAV9qanQiYppykfEUBGYRzmItdSyM4IxiDCApJWbJEiFNQgCI4JgROkJ3fey2XRaQGii73dW2toWu96rSVv3tlHatVtVOSYolToQPuD4E1NV7689ThXUG8lyXULVOES-OUik49-hNj5q6cq6G7GcMjlTnXXXe1Zd3D1_9XuwH_RbtAdwDHzaH_T9R6uV5QvrQT5uLjeE</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Scott, Nick</creator><creator>Sacks‐Davis, Rachel</creator><creator>Wade, Amanda J</creator><creator>Stoove, Mark</creator><creator>Pedrana, Alisa</creator><creator>Doyle, Joseph S</creator><creator>Thompson, Alexander J</creator><creator>Wilson, David P</creator><creator>Hellard, Margaret E</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202005</creationdate><title>Australia needs to increase testing to achieve hepatitis C elimination</title><author>Scott, Nick ; Sacks‐Davis, Rachel ; Wade, Amanda J ; Stoove, Mark ; Pedrana, Alisa ; Doyle, Joseph S ; Thompson, Alexander J ; Wilson, David P ; Hellard, Margaret E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4204-51fe5ba3ca9683d56f5de61401f8a7a86c654311ee7332cb4967c92ee2651423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Epidemiology</topic><topic>Hepatitis, viral</topic><topic>Infectious Diseases</topic><topic>Research and Reviews</topic><topic>Statistics, Epidemiology and Research Design</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scott, Nick</creatorcontrib><creatorcontrib>Sacks‐Davis, Rachel</creatorcontrib><creatorcontrib>Wade, Amanda J</creatorcontrib><creatorcontrib>Stoove, Mark</creatorcontrib><creatorcontrib>Pedrana, Alisa</creatorcontrib><creatorcontrib>Doyle, Joseph S</creatorcontrib><creatorcontrib>Thompson, Alexander J</creatorcontrib><creatorcontrib>Wilson, David P</creatorcontrib><creatorcontrib>Hellard, Margaret E</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical journal of Australia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scott, Nick</au><au>Sacks‐Davis, Rachel</au><au>Wade, Amanda J</au><au>Stoove, Mark</au><au>Pedrana, Alisa</au><au>Doyle, Joseph S</au><au>Thompson, Alexander J</au><au>Wilson, David P</au><au>Hellard, Margaret E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Australia needs to increase testing to achieve hepatitis C elimination</atitle><jtitle>Medical journal of Australia</jtitle><addtitle>Med J Aust</addtitle><date>2020-05</date><risdate>2020</risdate><volume>212</volume><issue>8</issue><spage>365</spage><epage>370</epage><pages>365-370</pages><issn>0025-729X</issn><eissn>1326-5377</eissn><abstract>Objectives
To assess progress in Australia toward the 2030 WHO hepatitis C elimination targets two years after the introduction of highly effective direct‐acting antiviral (DAA) treatments.
Design
Analysis of quarterly data on government‐subsidised hepatitis C RNA testing and hepatitis C treatment in Australia, January 2013 – June 2018. Changes in testing and treatment levels associated with DAA availability were assessed in an autoregressive integrated moving average (ARIMA) statistical model, and the impact by 2030 of different levels of testing and treatment were estimated using a mathematical model.
Major outcome measures
Hepatitis C prevalence among people who inject drugs; annual hepatitis C incidence relative to 2015 levels; projections for the hepatitis C care cascade in 2030.
Results
The mean annual number of treatments initiated for people with hepatitis C increased from 6747 during 2013–2015 (before the introduction of DAAs) to 28 022 during 2016–18; the mean annual number of diagnostic RNA tests increased from 17 385 to 23 819. If current trends in testing and treatment continue (ie, 2018 testing numbers are maintained but treatment numbers decline by 50%), it is projected that by 2030 only 72% of infected people would be treated (by 2025 all people diagnosed with hepatitis C would be treated). The incidence of hepatitis C in 2030 would be 59% lower than in 2015, well short of the WHO target of an 80% reduction. The identification and testing of people exposed to hepatitis C must be increased by at least 50% for Australia to reach the WHO elimination targets.
Conclusion
Hepatitis C elimination programs in Australia should focus on increasing testing rates and linkage with care to maintain adequate levels of treatment.</abstract><cop>Australia</cop><pub>John Wiley and Sons Inc</pub><pmid>32167586</pmid><doi>10.5694/mja2.50544</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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source | Wiley Online Library - AutoHoldings Journals |
subjects | Epidemiology Hepatitis, viral Infectious Diseases Research and Reviews Statistics, Epidemiology and Research Design |
title | Australia needs to increase testing to achieve hepatitis C elimination |
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