1. Updated HCV Global Burden Estimates
S. Blach
April 13, 2016

2. HCV Disease Burden Models
Methodology
HCV Disease Burden Models
Reviewed all published work to estimate HCV prevalence and genotype distribution in all countries
Models have been developed for 160 countries, covering 99.7% of the world’s total population
Country Verified – Modeled HCV disease burden and intervention strategies to minimize future morbidity and mortality in 60 countries in collaboration with local experts & MoH and are in discussions with another 7 countries
Polaris Estimate – Modeled HCV disease burden and WHO recommended strategies in 35 countries using published data
Extrapolated Estimates – When no reliable data were available, modeled HCV disease burden for 58 countries using other countries as analogues or regional estimates
Country verified and Polaris estimates have been uploaded to Polaris Observatory website (
We classify the models into three categories

3. Country verified disease burden models capture more than 50% of the global prevalence of HCV
Extrapolated prevalence estimates account for only 12% of total viremic infections

4. HCV burden was verified in 60 countries, discussions are underway in 7 countries and 35 others were modeled using published data
Countries with HCV Epidemiology Data
Prevalence
(Viremic)
0.0%-0.6%
0.6%-0.8%
0.8%-1.3%
1.3%-2.9%
2.9%-6.7%
Grey countries do not have reliable estimates
Source: Polaris Observatory (

5. In 2015, 500K patients were treated and cured with DAAs.
An estimated 70 million (56 million – 90 million) individuals are infected with HCV (viremic), a prevalence of 1% (0.8%-1.2%) in 2016
Prevalence
(Viremic)
Total Infected
3,000,000
6,000,000
0.0%-0.6%
0.6%-0.8%
0.8%-1.3%
1.3%-2.9%
2.9%-6.7%
250,000
Income doesn’t match up with map
In 2015, 500K patients were treated and cured with DAAs.
Source: Polaris Observatory (

6. Updated published estimates, an aging population and a focus on viremic infections contribute to a lower estimated viremic prevalence
Loss due to more recent estimates for India and China, and the impact of time (mortality)
Viremic Rate of 70%
Updated estimate for Nigeria, impact of time, 500k cured patients in 2015
On this slide we would like to show how global prevalence estimates have changed over time
In the present analysis, all available data were adjusted for viremia, and the populations were aged to 2016 to account for mortality
Sources: Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence. Hepatology 2013; 57(4):
- Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal of Hepatology 2014; 61(1S): S45-S57.

7. 30 countries account for 80% of viremic infections, while 7 countries account for 80% of treated patients
Viremic HCV Infections (2016)
50% of Total
80% of Total
Number Treated (2015)
80% of Total
30 = 12%
Source: Polaris Observatory (

8. Conclusions
The present analysis reports a 2016 viremic prevalence estimate of 70 million (56 million – 90 million) viremic infections, using a disease burden modeling approach and accounting for mortality and cure
A small number of countries (30) account for over 80% of the global HCV burden
Country verified disease burden models are available for over 60 countries (>50% of viremic infections), with more countries anticipated to be verified over the next few years
HCV prevalence updates will be published and updated on the Polaris Observatory website ( on an annual basis to track the progress of HCV elimination efforts
Source: Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal of Hepatology 2014; 61(1S): S45-S57.

9. Appendix

10. HCV: Validated disease burden analyses completed – analysis reviewed and approved by local experts (60 countries/regions)
Africa
Australia
Oman
Denmark
Malta
Cameroon
Bahrain
Pakistan
Estonia
Netherlands
Egypt
Hong Kong
Qatar
European Union
Norway
Ethiopia
India
Saudi Arabia
Finland
Poland
Ghana
Indonesia
South Korea
France
Portugal
Nigeria
Iran
Taiwan
Germany
Romania
South Africa
Israel
Turkey
Greece
Russia
Americas
Japan
UAE
Hungary
Slovakia
Argentina
Jordan
Europe
Iceland
Slovenia
Brazil
Lebanon
Austria
Ireland
Spain
Canada
Malaysia
Belgium
Latvia
Sweden
Mexico
Mongolia
Croatia
Lithuania
Switzerland
Asia/ Pacific
New Zealand
Czech Republic
Luxembourg

11. HCV: Validated disease burden analyses underway (7 countries)
Americas
Africa
Asia/ Pacific
Europe
Chile
Uganda
Philippines
Bulgaria
Colombia
Viet Nam
Kuwait

12. HCV: Disease burden models built based on published data (35 countries/regions)
Africa
Americas
Asia/ Pacific
Europe
Algeria
Dominican Republic
Azerbaijan
Albania
Burkina Faso
Panama
Cambodia
Italy
Burundi
Puerto Rico
China
United Kingdom
Central African Republic
United States
Georgia
Chad
Iraq
Gabon
Kazakhstan
Kenya
Papua New Guinea
Libya
Singapore
Madagascar
Syria
Malawi
Thailand
Morocco
Ukraine
Tunisia
Uzbekistan
Uganda
Venezuela
Zimbabwe
Yemen

13. HCV: Disease burden models built based on analogues or regional averages (58 countries/regions)
Africa
Niger
El Salvador
Myanmar
Angola
Republic of Congo
Guadeloupe
Nepal
Benin
Rwanda
Guatemala
North Korea
Botswana
Senegal
Haiti
Palestine
DRC
Sierra Leone
Honduras
Sri Lanka
Eritrea
Somalia
Jamaica
Tajikistan
Gambia
South Sudan
Nicaragua
Turkmenistan
Guinea
Sudan
Paraguay
Europe
Guinea-Bissau
Tanzania
Peru
Belarus
Ivory Coast
Togo
Uruguay
Bosnia & Herzegovina
Lesotho
Zambia
Asia/ Pacific
Cyprus
Liberia
Americas
Afghanistan
Macedonia
Mali
Bolivia
Armenia
Moldova
Mauritania
Costa Rica
Bangladesh
Serbia
Mozambique
Cuba
Kyrgyzstan
Namibia
Ecuador
Laos

14. Comparison of Gower 2014 anti-HCV estimates with other published work

15. Comparison of Gower 2014 viremic HCV estimates with present analysis

16. 80% of the change in prevalence was attributable to 32 countries
Nigeria accounted for ~35% of the change in global prevalence, before considering its impact on regional estimates

17. 9 countries with the largest impact were using regional estimates