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. 2020 Feb 27;20(1):181.
doi: 10.1186/s12879-020-4898-y.

Eliminating viral hepatitis C in Belgium: the micro-elimination approach

Dana Busschots  1   2 , Samira Toghanian  3 , Rob Bielen  1   2 , Stina Salomonsson  3 , Özgür M Koc  1   2   4 , Greet Hendrickx  5 , Michel Jadoul  6 , Frederik Nevens  7 , Etienne Sokal  8 , Christian Brixko  9 , Kathelijne Peerlinck  10 , Ludwig Apers  11 , Geert Robaeys  1   2   7 , Jeffrey V Lazarus  12
Affiliations

Eliminating viral hepatitis C in Belgium: the micro-elimination approach

Dana Busschots et al. BMC Infect Dis. .

Abstract

Background: Hepatitis C virus is one of the leading causes of chronic liver disease and liver-related deaths worldwide. The estimated prevalence of chronic hepatitis C viral infection among the general Belgian population was 0.57% (n = 64,000) in 2015. Although Belgium has had a 'Hepatitis C Plan' since 2014, elimination efforts are unclear. This study employs the best available data and modelling estimates to define the burden of hepatitis C viral infection among key subgroups in Belgium, identify information gaps and propose potential approaches to screening, linkage to care and treatment, and cure.

Methods: We examined the peer-reviewed and grey literature since 2012 for data on the prevalence of hepatitis C viral infection in Belgium in key subgroups identified by national experts and in the literature. Ultimately, this research is primarily based on data provided by the key stakeholders themselves due to a lack of reliable data in the literature. Based on this, we modelled the treatment rates required to reach elimination of hepatitis C in several subgroups.

Results: Eleven potential subgroups were identified. There were no data available for two subgroups: generational cohorts and men who have sex with men. In six subgroups, fewer than 3000 people were reported or estimated to have hepatitis C infection. Migrants and people who inject drugs were the most affected subgroups, and children were the least affected subgroup. Only two subgroups are on target to achieve elimination by 2030: patients living with haemophilia and transplant recipients.

Conclusions: Removing Belgian treatment reimbursement restrictions in January 2019 was a big step towards eliminating HCV. In addition, increasing surveillance, including with a national registry, treatment prescription by other health-care providers and availability of treatment in local pharmacies are central to improving the current situation and getting on track to reach the 2030 WHO hepatitis C elimination targets in Belgium.

Keywords: Belgium; Disease elimination; Health policy; Hepatitis C; Treatment.

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Conflict of interest statement

D.B. has received travel grants from AbbVie. S.T. and S.S are employees of MSD. R.B. has received travel grants from AbbVie, Gilead Sciences and MSD to attend scientific congresses and research grants from Gilead and MSD. Ö.K. has received a travel grant and research grants from Gilead. G.H. declares to be member of the VHPB secretariat for which the University of Antwerp obtains unrestricted grants from different vaccine and pharma manufacturers (AbbVie, Gilead, GlaxoSmithKline Biologicals, Merck, MSD and Sanofi Pasteur). M.J. has received speaker/ consultancy fees from MSD and AbbVie, and a research grant from MSD. F.N. has received research grants, consultancy agreements and travel grants from AbbVie, Astellas, BMS, CAF, Durect, Ferring, Gilead Sciences, Gore, Janssen-Cilag, Intercept, Ipsen, MSD, Novartis, Ono Pharma, Promethera Biosciences, and UCB. E.S. is an advisor for AbbVie, and investigator for Gilead, Roche. He is the founder and CMO of Promethera Biosciences. B.C. has received travel grants from Abbvie, Gilead and MSD to attend scientific meetings. K.P. declares no conflict of interest. L.A. declares no conflict of interest. G.R. has received research grants from AbbVie, Janssen Pharmaceuticals, MSD, and has acted as a consultant/advisor for AbbVie, BMS, Gilead Sciences and MSD. J.V.L. has received speaker fees and research grants from AbbVie, Gilead Sciences and MSD. The funders provided the mathematical model used for calculations. All data were provided by the other co-others.

References

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