key: cord-0729727-wyymmfur
authors: Buti, Maria; Domínguez-Hernández, Raquel; Casado, Miguel Angel
title: Impact of the COVID 19 Pandemic on HCV Elimination in Spain
date: 2020-12-20
journal: J Hepatol
DOI: 10.1016/j.jhep.2020.12.018
sha: 84b6cb3d5826752da8dd81d8319c8e29a74ea41a
doc_id: 729727
cord_uid: wyymmfur

nan

We read with great interest the article by Sarah Blach and coworkers 1 investigating the impact of COVID-19 on the global hepatitis C elimination efforts. The authors show that over the next 10 years a 1-year delay scenario related to COVID-19 would result in 44,800 excess hepatocellular carcinoma (HCC) cases globally and 72,300 excess liverrelated deaths, relative to a no delay scenario. The excess HCC cases and deaths would be among high-income countries 1 .

Spain is one of the 45 high-income countries on the right track to reach HCV elimination by 2030 if the current screening and therapy rates are maintained 2 .

However, COVID-19 strongly hit the country in March 2020 and continues to date. The first wave from March to June prompted a country-wide lockdown and the second wave has been ongoing since September. During this overall period, there has been a drop in HCV testing, linkage to care, harm reduction programs, and microelimination programs 3 . We aimed to assess the impact of COVID-19 on hepatitis C elimination in Spain.

A previously validated Markov model 4 The data we report were estimated with a different methodology than that used by Blach 1 in her study on the global impact of COVID 19 on hepatitis C elimination.

Nonetheless, the findings are similar: delaying HCV elimination programs will be associated with an increase in HCV-related morbidity and mortality in the next 10 years.

Spain was on track for HCV elimination, but the COVID-19 pandemic has hindered efforts to maintain the cascade of care for HCV and many microelimination programs 7 .

The excess morbidity and mortality due to this delay will require reinforcement of screening programs, particularly in vulnerable populations and those with more difficult access to primary care physicians 8 . This will be possible mainly by applying the EASL guideless for hepatitis C 9 . In summary, hepatitis C elimination must continue to be a political goal and a priority of our health system to achieve the WHO goals by 2030.

The implementation of actions like telehealth, home-delivery services for drugs or HCV screening when COVID tests are performed, some of them already in place in some centers, could minimize the impact of COVID pandemic on HCV patients and HCV elimination.

J o u r n a l P r e -p r o o f 

Impact of COVID-19 on global HCV elimination efforts

Global timing of hepatitis C virus elimination in high-income countries: an updated analysis

The impact of the COVID-19 pandemic on harm reduction services in Spain

Cost-effectiveness analysis of two treatment strategies for chronic hepatitis C before and after access to direct-acting antivirals in Spain

Plan Estratégico para el abordaje de la Hepatitis C en el SNS (PEAHC)

Grupo de trabajo del estudio de prevalencia de la infección por hepatitis C en población general en España

Guía de cribado de la infección por el VHC. Ministerio de Sanidad

Global health sector strategy on viral hepatitis 2016-2021, Towards ending viral hepatitis

Impact of COVID-19 on the care of patients with liver disease: EASL-ESCMID position paper after 6 months of the pandemic