Hepatitis B
Imperial hepB model
Brief description of model:
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The model is a dynamic, deterministic mathematical transmission model of the global hepatitis B epidemic structured by age, sex, and region. The model is composed of 21 Global Burden of Disease world regions, and is fitted to data on hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) prevalence, at two time points, and liver cancer deaths for each region independently.
The model incorporates region-specific demographic data on population size, mortality, and fertility schedules, coverage of existing interventions (infant vaccination, birth-dose vaccination, and treatment availability), and assumptions about the natural history of HBV. In the model, mother-to-child transmission, transmission between children, and transmission across the whole population (which includes other forms of transmission including sexual and iatrogenic) are included, the relative strengths of which are inferred through the calibration procedure.
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Cost of combined interventions and ratio of HBV and HIV treatment need.
(A) Cost of combined interventions with and without cure. The solid lines represent the cost of the combined interventions in the absence of a cure. The dotted lines represent the costs with the introduction of a cure in 2025. The blue lines represent the total global cost. The red lines represent the costs incurred in LICs and LMICs only (as defined by the World Bank in 201430).
(B) Ratio of people requiring treatment for HBV (modelled estimates for 2025) to people requiring treatment for HIV (HIV estimate from UNAIDS 201331). HBV=hepatitis B virus. LICs=low-income countries. LMICs=lower-middle-income countries.
From Nayagam, S., Thursz, M., Sicuri, E., Conteh, L., Wiktor, S., Low-Beer, D. L., & Hallett, T. B. (2016).
Requirements for global elimination of hepatitis B: a modelling study. Lancet Infectious Diseases, 16(12), 1399-1408. Licensed under a Creative Commons Attribution License
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Model code (where available):
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Burnet hepB model
Brief description of model:
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The model, developed using an open-source Python based compartmental modelling package (Atomica; see https://atomica.tools), is a dynamic deterministic model of hepatitis B. The model is age and sex structured within each modelled country and calibrated against hepatitis B surface antigen (HBsAg) seroprevalence, hepatocellular carcinoma (HCC) and cirrhosis mortality.
Transmission within the model is broken into three components: vertical (mother-to-child) transmission, early childhood horizontal transmission, and adult (<5 years) horizontal transmission. Rates of horizontal transmission are derived from calibration against HBsAg seroprevalence data, while rates of mother-to-child transmission are a function of maternal prevalence, birth dose vaccination and treatment coverage.
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Health and economic outcomes at the global level from Seaman et al 2023. Results highlight the importance, and economic benefits, of not delaying hepatitis B elimination efforts.
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Seaman CP, Luong P, Xiao Y, Abeysuriya R, Howell J, Hellard M, Scott N. A global investment case for hepatitis B elimination: a modelling study. Lancet Gastroenterology & Hepatology. 2023 Jul 27;8:932–942. DOI: 10.1016/S2468-1253(23)00156-5.
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Model code (where available):
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