Achieving WHO recommendations for Hepatitis C Virus Elimination in Belgium.

BACKGROUD: The World Health Organization (WHO) released updated guidelines for the screening, care and treatment of patients with chronic hepatitis C virus (HCV) infection. METHODS: A previously described HCV disease burden model was used to develop a "WHO scenario" to achieve the WHO recommendations of a 90% reduction in incidence and 65% reduction in liver-related deaths. After determining the steps necessary to achieve this goal, the impact of realistic constraints was modeled. RESULTS: In 2015, there were 66.200 viremic infections, with 43% diagnosed and 1.350 treated. In order to reduce new infections, treatment must be extended to ≥ F0 patients, including people who inject drugs and other individuals at risk of transmitting HCV. -Additionally, diagnosis and treatment of 3.030 and 4.060 patients, respectively, would be required. The largest attenuation of the WHO scenario would occur if no new cases were diagnosed after 2018 (300% more viremic infections by 2030). Limiting treatment to ≥ F2 patients or treating fewer patients (3.000) would result in 220% or 140% more viremic cases, respectively, compared with the WHO scenario. CONCLUSION: Achieving the WHO guidelines in Belgium requires a coordinated effort to scale up treatment and prevention efforts and to allow treatment access to patients of all fibrosis stages. A scale-up of treatment, however, requires patients to be both diagnosed and linked to care, suggesting a need for increased awareness and expanded screening efforts. Finally, prevention of new HCV infections requires a comprehensive understanding of the population at risk of transmitting HCV.

Annual stability in the levels of lymphocyte subpopulations identified by monoclonal antibodies in blood of healthy individuals.

The absolute numbers and percentages of lymphocytes, monocytes, and lymphocyte subpopulations in the blood mononuclear cells were examined monthly in two healthy individuals over a 22-month period. The object of this study was to determine whether the levels of lymphocyte subpopulations identified by monoclonal antibodies, Leu4+ (T), Leu3+ (helper T), Leu2+ (suppressor/cytotoxic T), and Leu7+ (natural killer) cells, were stable during the year for healthy donors. The results were analyzed by the cosiner method to estimate the rhythmicity of these subpopulations. The number of lymphocytes varied, showing a moderate circannual rhythm with a peak in early summer, whereas the number of monocytes also varied but its variation did not show a specific rhythm. The absolute numbers of T-lymphocyte subpopulations and Leu3+ and Leu2+ cells showed a covariation, with a peak in early summer in parallel with the circannual rhythm of total lymphocyte counts. A subpopulation of granular lymphocytes with natural killer function, Leu7+ cells, also showed a significant variation during the year. Of particular interest is that Leu3/Leu2 ratios were considerably stable during the year. The two-time point examination of these lymphocyte markers including HB-2+ B cells in August and January in 15 normal donors did not show any significant differences, although the mean values were slightly higher in summer. The stability and variability of these lymphocyte markers are displayed graphically and the details of these variations are listed.