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Global Distribution of HCV Infection

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Presentation on theme: "Global Distribution of HCV Infection"— Presentation transcript:

1 Global Distribution of HCV Infection

2 HCV Disease Burden Modeling

3 HCV Disease Progression
Acute Hepatitis Spontaneously Cured Chronic Hepatitis – F0 Chronic Hepatitis – F1 Chronic Hepatitis – F2 Chronic Hepatitis – F3 Compensated Cirrhosis Hepatocellular Carcinoma Decompensated Cirrhosis Liver Related Death Liver Transplantation Razavi H, Waked I, Sarrazin C, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm. J Viral Hepat 2014; 21 Suppl 1:

4 HCV Disease Progression Modeling
Acute HCV Infection Spontaneously Cured F0 – New Cases (NC) F1 (NC) F2 (NC) F3 (NC) Comp Cirrhosis (NC) F0 – Total Cases (TC) F1 (TC) F2 (TC) F3 (TC) Comp. Cirrhosis (TC) Background Mortality + Cured Diuretic Sensitive Ascites (NC) Variceal Hemorrhage (NC) Hepatic Encephal. (NC) Hepatocellular Carcinoma (NC) Diuretic Sensitive Ascites (TC) Variceal Hemorrhage (TC) Hepatic Encephal. (TC) Hepatocellular Carcinoma (TC) Refractory Ascites (NC) Liver Transplantation Liver Related Mortality Refractory Ascites (TC)

5 HCV Disease Burden Model Characteristics
Easy to use platform – Excel based model Transparent – All formulas are unprotected and visible Ties to historical data – Published data is used to calibrate the model up to 2013 Measures the impact of future decisions – Interface to input potential strategies

6 The epidemiology of hepatitis C can be explained using a leaky bucket as an analogy
New HCV Infections At any point in time, the total number of individuals infected with HCV can be explained by the number of new infections, cured, and mortality since the beginning of time. Cured Mortality

7 HCV Disease Burden – A Comparison

8 Viremic HCV prevalence, 1950-2030 Germany, England, France and Spain
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

9 Viremic HCV prevalence, 1950-2030 Brazil, Egypt, Australia and Turkey
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

10 Age distribution, 2013 Germany, England, France and Spain
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

11 Age distribution, 2013 Brazil, Egypt, Australia and Turkey
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

12 HCC, decompensated cirrhosis and transplant, 1950-2030 Germany, England, France and Spain
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

13 HCC, decompensated cirrhosis and transplant, 1950-2030 Brazil, Egypt, Australia and Turkey
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. J Viral Hepat 2014;21 Suppl 1:34-59.

14 Estimated viremic infections, 2013-2030 Germany, England, France and Spain
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

15 Estimated viremic infections, 2013-2030 Brazil, Egypt, Australia and Turkey
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

16 Cirrhosis, 2013-2030 Germany, England, France and Spain
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

17 Cirrhosis, 2013-2030 Brazil, Egypt, Australia and Turkey
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

18 HCC, 2013-2030 Germany, England, France and Spain
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

19 HCC, 2013-2030 Brazil, Egypt, Australia and Turkey
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

20 Liver-related deaths, 2013-2030 Germany, England, France and Spain
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

21 Liver-related deaths, 2013-2030 Brazil, Egypt, Australia and Turkey
Wedemeyer H, Duberg AS, Buti M, et al. J Viral Hepat 2014; 21 Suppl 1:

22 Historical distribution by age and gender Germany, England, France and Spain
Bruggmann P, Berg T, Ovrehus AL, et al. J Viral Hepat 2014; 21 Suppl 1: 5-33.

23 Historical distribution by age and gender Brazil, Egypt, Australia and Turkey
Bruggmann P, Berg T, Ovrehus AL, et al. J Viral Hepat 2014; 21 Suppl 1: 5-33.

24 HCV Prevalence

25 Anti-HCV prevalence (Data Quality)
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

26 Anti-HCV Prevalence (Reported)
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

27 Anti-HCV Prevalence (Reported + Extrapolated)
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

28 Viremic HCV Prevalence (Reported)
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

29 Viremic HCV Prevalence (Reported + Extrapolated)
Prevalence (Viremic) 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

30 Total Viremic HCV Infections (Reported + Extrapolated)
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

31 HCV Viremic Infections (Prevalence & Total Infected)
200K-650K 650K-1.9M 0-200K 1.9M-3.5M 3.5M-9.2M Prevalence 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

32 Total Viremic HCV Infections Countries Responsible for 80% of Global Infections
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

33 HCV Genotype Distribution

34 Genotype Distribution, by Global Burden of Disease (GBD) Region
Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

35 HCV Genotype Distribution Globally
48% Genotype 2 14% Genotype 3 22% Genotype 4 13% Genotype 5 1% Genotype 6 2% Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Global epidemiology and genotype distribution of the hepatitis C virus, Journal of Hepatology (2014)

36 Genotype Distribution by World Bank Regions
Razavi H, Gower E, Estes C, Hindman S. Global HCV Genotypes. Poster presented at: The Liver Meeting 2013; 2013 Nov 1-5; Washington, DC, United States.

37 Genotype Distribution by Region
North America Europe, Western Europe, Central Europe, Eastern Asia, Central Asia Pacific, High Income Asia, South Caribbean Asia, Southeast Latin America, Central Asia, East Latin America, Tropical Australasia Latin America, Southern Latin America, Andean North Africa/Middle East Sub-S Africa, Central Sub-S Africa, Southern Sub-Saharan Africa, West Razavi H, Gower E, Estes C, Hindman S. Global HCV Genotypes. AASLD 2013; 2013 Nov 1-5; Washington, DC, United States.

38 Genotype Distribution by Region
North America Europe, Western Europe, Central Europe, Eastern Asia, Central Asia Pacific, High Income Asia, South Caribbean Asia, Southeast Latin America, Central Asia, East Latin America, Tropical Australasia Latin America, Southern Latin America, Andean North Africa/Middle East Sub-S Africa, Central Sub-S Africa, Southern Sub-Saharan Africa, West Razavi H, Gower E, Estes C, Hindman S. Global HCV Genotypes. AASLD 2013; 2013 Nov 1-5; Washington, DC, United States.

39 HCV Prevalence and Genotype Distribution Europe
United Kingdom Czech Republic Ireland Norway Denmark Sweden Finland Hungary Slovakia Poland Lithuania Latvia Belarus Russia France Switzerland Germany Austria Netherlands Serbia Romania Belgium Luxembourg Georgia Estonia Prevalence (Viremic) 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Total Infected (Viremic) 200K-650K 650K-1.9M 0-200K 1.9M-3.5M Turkey Armenia Bosnia & Herzegovina Portugal Spain Italy Greece Slovenia Croatia Montenegro Albania Macedonia Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Journal of Hepatology (2014)

40 HCV Prevalence and Genotype Distribution Africa & Middle East
Morocco Algeria Tunisia Libya Egypt Palestine Israel Lebanon Syria Jordan Kuwait Iraq Guinea Bissau Gambia Saudi Arabia Iran UAE Burkina Faso Ghana Central African Republic Ethiopia Congo Equatorial Guinea Nigeria Mozambique Madagascar Gabon Prevalence (Viremic) 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Total Infected (Viremic) 200K-650K 650K-1.9M 0-200K 1.9M-3.5M 3.5M-9.2M South Africa Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Journal of Hepatology (2014)

41 HCV Prevalence and Genotype Distribution Central Asia, South East Asia & Australia Pacific
Tajikistan Mongolia Uzbekistan Japan Prevalence (Viremic) 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Hong Kong Pakistan Total Infected (Viremic) 200K-650K 650K-1.9M 0-200K 1.9M-3.5M 3.5M-9.2M India Korea Sri Lanka China New Zealand Vietnam Myanmar Thailand Cambodia Indonesia Malaysia Laos Philippines Australia Taiwan Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Journal of Hepatology (2014)

42 HCV Prevalence and Genotype Distribution Latin America
Dominican Republic Cuba Mexico Puerto Rico Venezuela Colombia Peru Brazil Prevalence (Viremic) 0.0%-0.6% 0.6%-0.8% 0.8%-1.3% 1.3%-2.9% 2.9%-7.8% Total Infected (Viremic) 200K-650K 650K-1.9M 0-200K Chile Argentina Gower, E., Estes C., Hindman, S., Razavi-Shearer, K., Razavi, H., Journal of Hepatology (2014)

43 HCV Treatment Rate

44 Treatment Rate, by Country, 2013
Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm. J Viral Hepat 2014;21 Suppl 1:34-59. Hatzakis A, Chulanov V, Gadano AC, Bergin C, Ben-Ari Z, Mossong J, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm – J Viral Hepat Submitted for publication 30 July 2014.


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