Coronavirus disease 2019 (COVID-19) has placed a significant strain on national healthcare systems at a critical moment in the context of hepatitis elimination. Mathematical models can be used to evaluate the possible impact of programmatic delays on hepatitis disease burden. The objective of an analysis, published in the Journal of Hepatology, was to evaluate the incremental change in HCV liver-related deaths and liver cancer, following a 3-month, 6-month, or 1-year hiatus in hepatitis elimination programs.
The ‘1-year delay’ scenario resulted in 44,800 excess hepatocellular carcinoma (HCC) cases and 72,300 excess liver-related deaths, relative to the ‘no-delay’ scenario globally, from 2020 to 2030. Most missed treatments would be in lower-middle income countries, whereas most excess hepatocellular carcinoma and liver-related deaths would be among high-income countries.
The full analysis can be accessed here.
A related note in the Journal of Hepatology presented data on the impact of the COVID-19 pandemic on HCV elimination in Spain.
An 18-month delay in HCV diagnosis and treatment due to the COVID pandemic in a cohort of 15,859 patients would increase the number of liver-related deaths, HCC, and HCV-related decompensated cirrhosis by 117, 73, and 118 cases, respectively. In economic terms this would translate into a 1.0 M€ cost increase due to decompensated cirrhosis and a 1.3 M€ increase due to HCC. Furthermore, a high number of patients (34 vs. 48) would need a liver transplant due to decompensated cirrhosis or HCC. The cost associated with liver transplantation would increase by 2.5 M€ (5.8 vs. 8.3) for the total cohort during this period.