The burden of chronic hepatitis C in China from 2004 to 2050: an individual‐based modeling study

Abstract

The launch of novel direct‐acting antivirals (DAAs) is expected to substantially reduce the burden of HCV in China. However, the effect of these changes has not yet been modeled in China. Therefore, we aim to predict the burden of HCV‐related diseases in China by simulating different scenarios that incorporate recent therapeutic advances of HCV and China's current screening strategy. We developed an individual‐based microsimulation Markov model that simulated the disease progression of HCV‐infected patients in China from 2004 to 2050. We simulated 4 scenarios with different assumptions about treatment including a natural history scenario, a pre‐DAAs scenario, a DAAs (≥F3) scenario, and a DAAs (≥F0) scenario. The introduction of DAAs is predicted to have great impacts on the burden of HCV in China, particularly under the DAAs (≥F0) scenario in which we rapidly expand DAAs to all HCV‐infected patients (≥F0) in 2021. Under this scenario, the prevalence of chronic HCV is expected to peak at 10.75 million (95% CI: 8.30‐12.85 million) around 2020 and then decrease to 7.92 million (95% CI: 5.41‐10.08 million) in 2050.

Conclusion

If the future increasing burden of HCV‐related diseases is to be averted, China needs to start launching the novel DAA treatment and rapidly increase the number of treated. However, to maximize the benefits of new DAAs, expanded screening is necessary to identify more cases that require treatment in the short term. Without these changes, the HCV burden in China will remain high in the future.

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