Projected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study.
Projected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study.
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DOI：
10.1093/cid/ciab779
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发表时间：
2022-08-24
期刊：
影响因子：
--
通讯作者：
White LF
中科院分区：
文献类型：
--
作者：
Barocas JA;Savinkina A;Lodi S;Epstein RL;Bouton TC;Sperring H;Hsu HE;Jacobson KR;Schechter-Perkins EM;Linas BP;White LF
2019冠状病毒病（COVID-19）大流行扰乱了美国获得和接受丙型肝炎病毒（HCV）护理服务的机会。目前尚不清楚大流行将如何影响HCV相关的长期结果。我们使用微观模拟来估计COVID-19中断医疗服务对HCV结果的10年影响，包括已确定的感染、与护理的联系、治疗的开始和完成、肝硬化和肝脏相关死亡。我们对假设情景进行了建模，其中包括从2020年3月开始的为期18个月的与大流行相关的HCV护理中断，随后到2030年3月的筛查、联系和治疗率恢复到大流行前的不同水平，并将其与没有COVID-19大流行或护理中断的反事实情景进行了比较。我们还进行了替代情景分析，其中疫情中断持续了12个月和24个月。与“无大流行”情景相比，在HCV护理服务没有恢复到大流行前水平的情景中，我们估计每10万人中确定的病例减少了1060例，肝硬化病例增加了21例，肝脏相关死亡增加了16例。只有3%的确诊病例开始治疗，<1%的病例达到持续病毒学应答（SVR）。与“无大流行”相比，最好的情况是18个月的护理中断后恢复到大流行前的水平，我们估计发现并实现SVR的感染比例较小。为了克服COVID-19相关的中断，需要重新致力于美国的HCV流行，包括额外的资源，以及积极努力筛查、联系和治疗HCV感染者。在这项建模研究中，我们发现，由COVID-19大流行引起的美国HCV服务的获取和使用中断将导致HCV确诊病例减少，肝硬化和肝脏相关死亡病例增加。
The coronavirus disease 2019 (COVID-19) pandemic disrupted access to and uptake of hepatitis C virus (HCV) care services in the United States. It is unknown how substantially the pandemic will impact long-term HCV-related outcomes. We used a microsimulation to estimate the 10-year impact of COVID-19 disruptions in healthcare delivery on HCV outcomes including identified infections, linkage to care, treatment initiation and completion, cirrhosis, and liver-related death. We modeled hypothetical scenarios consisting of an 18-month pandemic-related disruption in HCV care starting in March 2020 followed by varying returns to pre-pandemic rates of screening, linkage, and treatment through March 2030 and compared them to a counterfactual scenario in which there was no COVID-19 pandemic or disruptions in care. We also performed alternate scenario analyses in which the pandemic disruption lasted for 12 and 24 months. Compared to the “no pandemic” scenario, in the scenario in which there is no return to pre-pandemic levels of HCV care delivery, we estimate 1060 fewer identified cases, 21 additional cases of cirrhosis, and 16 additional liver-related deaths per 100 000 people. Only 3% of identified cases initiate treatment and <1% achieve sustained virologic response (SVR). Compared to “no pandemic,” the best-case scenario in which an 18-month care disruption is followed by a return to pre-pandemic levels, we estimated a smaller proportion of infections identified and achieving SVR. A recommitment to the HCV epidemic in the United States that involves additional resources coupled with aggressive efforts to screen, link, and treat people with HCV is needed to overcome the COVID-19-related disruptions. In this modeling study, we found that disruptions in access to and uptake of HCV services in the U.S. caused by the COVID-19 pandemic will lead to fewer identified cases of HCV, and additional cases of cirrhosis and liver-related deaths.
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影响因子：
6
作者：
Evans, Elizabeth;Li, Libo;Nosyk, Bohdan
通讯作者：
Nosyk, Bohdan
影响因子：
3.7
作者：
Linas BP;Barter DM;Leff JA;Assoumou SA;Salomon JA;Weinstein MC;Kim AY;Schackman BR
通讯作者：
Schackman BR
DOI：
10.1186/s13011-021-00395-6
发表时间：
2021-08-09
期刊：
Substance abuse treatment, prevention, and policy
影响因子：
--
作者：
Alexander K;Pogorzelska-Maziarz M;Gerolamo A;Hassen N;Kelly EL;Rising KL
通讯作者：
Rising KL
影响因子：
15.1
作者：
Cilloni L;Fu H;Vesga JF;Dowdy D;Pretorius C;Ahmedov S;Nair SA;Mosneaga A;Masini E;Sahu S;Arinaminpathy N
通讯作者：
Arinaminpathy N
影响因子：
158.5
作者：
Curry, M. P.;O'Leary, J. G.;Charlton, M.
通讯作者：
Charlton, M.