Table 2.
Model parameters for each screening and treatment intervention scenario for 2018 onwards.
| Ab screening & re-screening | RNA re-screening of known Ab+ status | Referral | ||||||
|---|---|---|---|---|---|---|---|---|
| Intervention scenario | Primary Ab screening rate‡ | Re-screening rate of SVR and previously screened uninfected‡ | Previously treated | Rate previously diagnosed LTFU linked back to care | % diagnosed HCV infections linked to treatment | |||
| All | Gen.b | PWID | Gen. | PWID | Gen. | PWID | All | |
| Scenario S0. No further treatment from 2018 | -- | -- | -- | -- | -- | -- | -- | -- |
| Scenario SQ. ~150,000–160,000 treatments/year | 2.6–5.9% | -- | -- | -- | -- | -- | -- | 35–70% |
| Scenario S1. One-time 90% screen by 2030 with 80% referreda | 6.2% [6.1–6.3%] |
-- | -- | -- | -- | -- | -- | 80% |
| Scenario S2. S1+ Target primary Ab screening Age 30+ & PWID | 6.2% [6.1–6.3%] |
-- | -- | -- | -- | -- | -- | 80% |
| Scenario S3. S2+ Re-screen SVR & Ab/RNA- from 2020 | 6.2% [6.1–6.3%] |
10% | 100% | 10% | 100% | -- | -- | 80% |
| Scenario S4. S3+ Incremental improvements* | 12.4% [12.1–12.6%] |
20% | 100% | 20% | 100% | 20% | 100% | 90% |
A 6.2% [6.1–6.3%] annual primary screening rate is equivalent to first-time Ab screening 180 [175–185] million individuals, or 90% of the 2018 population, by 2030. Doubling this to a 12.4% [12.1–12.6%] annual primary screening rate is equivalent to first-time Ab screen 280 [265–290] million individuals, or 140% of the 2018 population, by 2030.
Gen: General population rate for non-PWID groups.
Incremental improvements to Scenario S3, namely, increase referral to 90%, double primary Ab screening rate, re-screening every 5 years, and re-engage RNA+ LTFU.
We assume that all persons tested Ab-positive, either from primary Ab screening (ψ1) or Ab re-screening (ψ2), are subsequently tested for HCV RNA, i.e. there is no loss-to-follow-up at this stage