Blueprint to hepatitis B elimination in China: A modelling analysis of clinical strategies

作者全名："Li, Rui; Shen, Mingwang; Ong, Jason J.; Cui, Fuqiang; Hu, Wenyi; Chan, Polin; Zou, Zhuoru; Su, Shu; Liu, Hangting; Zhang, Lei; Seto, Wai-Kay; Wong, William C. W."

作者地址："[Li, Rui; Shen, Mingwang; Ong, Jason J.; Zou, Zhuoru; Liu, Hangting; Zhang, Lei] Xi An Jiao Tong Univ, China Australia Joint Res Ctr Infect Dis, Hlth Sci Ctr, Sch Publ Hlth, Xian, Peoples R China; [Li, Rui; Ong, Jason J.; Zhang, Lei] Monash Univ, Fac Med, Cent Clin Sch, Melbourne, Vic, Australia; [Li, Rui; Ong, Jason J.; Zhang, Lei] Alfred Hlth, Melbourne Sexual Hlth Ctr, Artificial Intelligence & Modelling Epidemiol Prog, Melbourne, Vic, Australia; [Shen, Mingwang] Key Lab Dis Prevent & Control & Hlth Promot Shaanx, Xian, Peoples R China; [Cui, Fuqiang] Peking Univ, Sch Publ Hlth, 38 Xueyuan Rd, Beijing, Peoples R China; [Hu, Wenyi] Royal Victorian Eye & Ear Hosp, Ctr Eye Res Australia, Melbourne, Vic, Australia; [Hu, Wenyi] Univ Melbourne, Dept Surg Ophthalmol, Melbourne, Vic, Australia; [Chan, Polin] WHO, India Country Off, Communicable Dis Team, New Delhi, India; [Su, Shu] Chongqing Med Univ, Affiliated Hosp 2, Dept Epidemiol & Biostat, Chongqing, Peoples R China; [Seto, Wai-Kay] Univ Hong Kong, Shenzhen Hosp, Dept Med, Shenzhen, Peoples R China; [Seto, Wai-Kay] Univ Hong Kong, Dept Med, Hong Kong, Peoples R China; [Wong, William C. W.] Univ Hong Kong, Shenzhen Hosp, Dept Family Med, Shenzhen, Peoples R China; [Wong, William C. W.] Univ Hong Kong, Li Ka Shing Fac Med, Dept Family Med & Primary Care, Hong Kong, Peoples R China"

通信作者："Zhang, L (通讯作者)，Xi An Jiao Tong Univ, China Australia Joint Res Ctr Infect Dis, Hlth Sci Ctr, Sch Publ Hlth, Xian, Peoples R China.; Seto, WK (通讯作者)，Univ Hong Kong, Shenzhen Hosp, Dept Med, Shenzhen, Peoples R China.; Wong, WCW (通讯作者)，Univ Hong Kong, Li Ka Shing Fac Med, Dept Family Med & Primary Care, Hong Kong, Peoples R China."

来源：JHEP REPORTS

ESI学科分类：　

WOS号：WOS:001070368800001

JCR分区：Q1

影响因子：9.5

年份：2023

卷号：5

期号：10

开始页：　

结束页：　

文献类型：Article

关键词：HBV; WHO; HCC; Cirrhosis; Viral hepatitis

摘要："Background & Aims: Globally, one-third of individuals infected with HBV live in China. Eliminating HBV in China would therefore be paramount in achieving the World Health Organization's (WHO's) targets of viral hepatitis elimination as a worldwide public health threat. Methods: We constructed a dynamic HBV transmission model in China, structured by age and sex. We calibrated the model by HBsAg prevalence, acute HBV incidence, and nationally reported HBV-related cancer mortality. We investigated seven intervention scenarios (A-G) based on assumptions in diagnostic, linkage-to-care, and treatment coverages in achieving the WHO's HBV elimination goals. Results: With the status quo, HBsAg prevalence among children 1-4 years would reduce to 0.09% (95% CI 0.09-0.10%) by 2025; acute HBV incidence would drop to <2/100,000 person-years by 2024, achieving the elimination target of 90% incidence reduction. Nonetheless, China would not achieve a 65% reduction target in HBV-related mortality until 2059 with 9.98 (95% CI 9.27-10.70) million HBV-related deaths occurred by 2100. If China achieves 90% diagnostic and 80% treatment coverages (scenario E), HBV elimination would be achieved 8 years earlier, potentially saving 1.98 (95% CI 1.83-2.12) million lives. With more effective therapies for HBV control in preventing cirrhosis and hepatocellular carcinoma, elimination targets could be achieved in 2048 (scenario F) and 2038 (scenario G), additionally saving 3.59 (95% CI 3.37-3.82) and 5.19 (95% CI 4.83-5.55) million lives, respectively. Conclusions: Eliminating HBV will require interventional strategies to improve diagnostic, linkage-to-care, and treatment coverages. Developing novel therapies will be crucial in further reducing HBV-related mortality and removing HBV as a public health threat. Impact and Implications: This study explores the key developments and optimal intervention strategies needed to achieve WHO hepatitis B elimination targets by 2030 in China. It highlights that China can realise the HBV elimination targets in the incidence by 2025, and by upscaling diagnostic, linkage-to-care, and treatment coverages, up to 2 million lives could potentially be saved from HBV-related deaths. (c) 2023 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)."

基金机构："National Key Ramp;D Program of China [2022YFC2505100, 2022Y FC2505100]; National Natural Science Foundation of China [12171387, 81950410639]; Outstanding Young Scholars Funding [3111500001]; Xi'an Jiaotong University Basic Research and Profession Grant [xtr022019003, xzy032020032]; Xi'an Jiaotong University Young Talent Support Grant [YX6J004]; China Postdoctoral Science Foundation [2018M631134, 2020T130095ZX]; Young Talent Support Program of Shaanxi University Association for Science and Technology [20210307]; Natural Science Foundation of Chongqing [CSTB2023NSCQ-MSX0198]; Second Affiliated Hospital of Chongqing Medical University Basic Research Grant [2023II TXG26]"

基金资助正文："LZ is supported by the National Key R&D Program of China (2022Y FC2505100) , the National Natural Science Foundation of China (grant number 81950410639) , Outstanding Young Scholars Funding (grant number 3111500001) , Xi'an Jiaotong University Basic Research and Profession Grant (grant numbers xtr022019003 and xzy032020032) , and Xi'an Jiaotong University Young Talent Support Grant (grant number YX6J004) . MS is supported by the National Key R&D Program of China (2022YFC2505100) , the National Natural Science Foundation of China (12171387) , China Postdoctoral Science Foundation (2018M631134 and 2020T130095ZX) , and Young Talent Support Program of Shaanxi University Association for Science and Technology (20210307) . SS is supported by the Natural Science Foundation of Chongqing (CSTB2023NSCQ-MSX0198) and The Second Affiliated Hospital of Chongqing Medical University Basic Research Grant (2023II TXG26) ."