Impact of HCV antiviral therapy on the Liver Transplantation Waiting-List assessed by mathematical models

E. Chaib, João Luís Erbs Pessoa, M. Medeiros, E. Massad
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Abstract

In this paper we analyze, through a mathematical model, the potential impact of HCV antiviral therapy on the liver transplantation waiting list (LTWL) in the State of Sao Paulo, Brazil. In previous papers, we projected the size of the waiting list by taking into account the incidence of new patients per year, the number of transplantations carried out in that year, and the number of patients that died in the waiting list. In the present work, we projected the LTWL size for the next 30 years and we introduced the anti-HCV treatment, which was assumed to half the incidence of patients in the LTWL and that the recovery of patients in the list would triple. The liver transplantation rate was assumed to not be affected by the anti-HCV treatment. Our mathematical model demonstrates that anti-HCV therapy would have a remarkable impact on the size of the LTWL, in the State of Sao Paulo, dropping from twenty-four thousand to approximately twelve hundred patients in the next 30 years.
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用数学模型评估丙型肝炎病毒抗病毒治疗对肝移植等待名单的影响
在本文中,我们通过一个数学模型分析了HCV抗病毒治疗对巴西圣保罗州肝移植等待名单(LTWL)的潜在影响。在之前的论文中,我们通过考虑每年新患者的发生率、当年进行的移植数量以及在等待名单中死亡的患者数量来预测等待名单的规模。在目前的工作中,我们预测了未来30年LTWL的规模,并引入了抗hcv治疗,假设LTWL中患者的发病率为一半,并且列表中患者的恢复将增加两倍。假设肝移植率不受抗hcv治疗的影响。我们的数学模型表明,抗hcv治疗将对圣保罗州LTWL的规模产生显著影响,在未来30年内,LTWL的患者数量将从2.4万人减少到大约1200人。
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