Projections of the current and future disease burden of hepatitis C virus infection in Malaysia

Scott A. McDonald, Maznah Dahlui, Rosmawati Mohamed, Herlianna Naning, Fatiha Hana Shabaruddin, Adeeba Kamarulzaman

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Abstract

Background
The prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods.
Methods
An age-structured multi-state Markov model was developed to simulate the natural history of HCV infection.We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from
2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed.
Results
In the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039.
Conclusions
The HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.
Original languageEnglish
Article numbere0128091
Number of pages15
JournalPLoSONE
Volume10
Issue number6
DOIs
Publication statusPublished - 4 Jun 2015

Fingerprint

Malaysia
Virus Diseases
Hepacivirus
Quality-Adjusted Life Years
Antiviral Agents
Fibrosis
End Stage Liver Disease
Incidence
Natural History
Hepatitis
Hepatocellular Carcinoma
Population

Keywords

  • hepatitis C
  • antiviral therapy
  • Malasia
  • cirrhosis
  • public health

Cite this

McDonald, S. A., Dahlui, M., Mohamed, R., Naning, H., Hana Shabaruddin, F., & Kamarulzaman, A. (2015). Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. PLoSONE, 10(6), [e0128091]. https://doi.org/10.1371/journal.pone.0128091
McDonald, Scott A. ; Dahlui, Maznah ; Mohamed, Rosmawati ; Naning, Herlianna ; Hana Shabaruddin, Fatiha ; Kamarulzaman, Adeeba. / Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. In: PLoSONE. 2015 ; Vol. 10, No. 6.
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McDonald, SA, Dahlui, M, Mohamed, R, Naning, H, Hana Shabaruddin, F & Kamarulzaman, A 2015, 'Projections of the current and future disease burden of hepatitis C virus infection in Malaysia', PLoSONE, vol. 10, no. 6, e0128091. https://doi.org/10.1371/journal.pone.0128091

Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. / McDonald, Scott A.; Dahlui, Maznah; Mohamed, Rosmawati; Naning, Herlianna; Hana Shabaruddin, Fatiha; Kamarulzaman, Adeeba.

In: PLoSONE, Vol. 10, No. 6, e0128091, 04.06.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Projections of the current and future disease burden of hepatitis C virus infection in Malaysia

AU - McDonald, Scott A.

AU - Dahlui, Maznah

AU - Mohamed, Rosmawati

AU - Naning, Herlianna

AU - Hana Shabaruddin, Fatiha

AU - Kamarulzaman, Adeeba

PY - 2015/6/4

Y1 - 2015/6/4

N2 - BackgroundThe prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods.MethodsAn age-structured multi-state Markov model was developed to simulate the natural history of HCV infection.We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed.ResultsIn the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039.ConclusionsThe HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.

AB - BackgroundThe prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods.MethodsAn age-structured multi-state Markov model was developed to simulate the natural history of HCV infection.We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed.ResultsIn the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039.ConclusionsThe HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.

KW - hepatitis C

KW - antiviral therapy

KW - Malasia

KW - cirrhosis

KW - public health

U2 - 10.1371/journal.pone.0128091

DO - 10.1371/journal.pone.0128091

M3 - Article

VL - 10

IS - 6

M1 - e0128091

ER -

McDonald SA, Dahlui M, Mohamed R, Naning H, Hana Shabaruddin F, Kamarulzaman A. Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. PLoSONE. 2015 Jun 4;10(6). e0128091. https://doi.org/10.1371/journal.pone.0128091