Simulation Modeling of Hepatitis B Virus Elimination Strategies in Cote d'Ivoire

科特迪瓦乙型肝炎病毒消除策略的模拟建模

• 批准号: 10525126
• 负责人: Amir Mohareb
• 金额: $ 13.58万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10525126
• 关键词: Address; Adult; Africa; Africa South of the Sahara; Antiviral Agents; Antiviral Therapy; Area; Award; Biometry; Caring; Cessation of life; Chronic Hepatitis B; Cirrhosis; Clinical; Clinical Investigator; Clinical Practice Guideline; Collaborations; Communicable Diseases; Complex; Computer Simulation; Cost Effectiveness Analysis; Country; Data; Derivation procedure; Diagnostic; Diagnostic tests; Disease; Drug Side Effects; Economics; Eligibility Determination; Europe; Far East; Flare; Foundations; Future; Goals; Guidelines; HIV/TB; Health Benefit; Healthcare; Hepatitis; Hepatitis B; Hepatitis B Infection; Hepatitis B Therapy; Hepatitis B Virus; Immunotherapy; Incidence; International; Investigation; Ivory Coast; Laboratories; Liver; Liver Fibrosis; Malaria; Malignant neoplasm of liver; Measures; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Modeling; Monitor; North America; Nucleic Acid Amplification Tests; Outcome; Patients; Persons; Physicians; Policy Maker; Positioning Attribute; Prevention; Primary carcinoma of the liver cells; Public Health; Records; Research; Research Personnel; Research Project Grants; Resource-limited setting; Resources; Safety; Solid; Strategic Planning; Training; United States National Institutes of Health; Vaccination; Vaccines; Viral; Viral hepatitis; Virus; Withholding Treatment; World Health Organization; alternative treatment; base; career; chronic liver disease; clinical epidemiology; cost; cost effectiveness; design; design verification; didactic education; economic outcome; elastography; evidence base; fight against; improved; liver biopsy; model design; models and simulation; mortality; mortality risk; multidisciplinary; multiple data sources; novel; prevent; scale up; skills; standard of care; success; tool; treatment guidelines; treatment strategy; viral DNA; years of life lost

Project Summary Hepatitis B virus (HBV) is the world's leading cause of cirrhosis, liver cancer, and liver-related mortality. Its burden is increasing around the world, especially in sub-Saharan Africa. Even though millions of people across sub-Saharan Africa are known to have chronic hepatitis B infection, very few eligible patients are started on treatment. The complexity and cost of laboratory monitoring, liver fibrosis assessments, and antiviral treatment are some of the major challenges preventing scale-up of treatment. My goal is to determine whether hepatitis B management guidelines can be simplified so that limited healthcare resources are focused on expanding hepatitis B treatment in resource-limited settings. Simulation models are evidence-based tools that are increasingly being used by investigators to address complex questions such as this, by assessing the long-term clinical impact of existing as well as novel hepatitis B treatment initiation strategies. I am an Infectious Diseases physician with a research background in clinical epidemiology, simulation modeling, and cost-effectiveness analysis. I am motivated to expand on my current skillset and gain training to apply these methodologies to investigate HBV treatment strategies in sub-Saharan Africa. The Mentored Research Scientist Development Award will afford me the opportunity to gain the necessary skills to become an independent clinical investigator. I require specific training in (1) model design and validation; (2) derivation of clinical and economic outcome data; and (3) designing and executing cost-effectiveness analyses. I have designed a didactic curriculum to address each of these training aims. I have also assembled a multi-disciplinary team of mentors and collaborators with methodological and/ or content expertise who are devoted to my success in achieving the aims of this proposal. By the end of the award period, I will have designed and validated a novel HBV simulation model, populated the model with clinical and economic data from sub-Saharan Africa, and used the model conduct a high impact cost-effectiveness analysis that has the potential to guide HBV management across the continent.

项目摘要 肝炎病毒（HBV）是肝硬化，肝癌和与肝有关的世界主要原因 死亡。它的负担正在增加世界各地，尤其是在撒哈拉以南非洲。虽然 众所周知，撒哈拉以南非洲以百万计的人患有慢性乙型肝炎感染，很少 合格的患者开始接受治疗。实验室监测的复杂性和成本，肝脏 纤维化评估和抗病毒治疗是阻止规模扩大的一些主要挑战 治疗。 我的目标是确定是否可以简化丙型肝炎管理指南，以便有限 医疗保健资源专注于在资源有限的环境中扩大丙型肝炎治疗。 仿真模型是基于证据的工具，研究人员越来越多地使用它们 通过评估现有的长期临床影响来解决此类复杂问题 作为新型的乙型肝治疗启动策略。我是一个感染性疾病医师 临床流行病学，模拟建模和成本效益分析的研究背景。我 有动力扩大我当前的技能和获得培训，以将这些方法应用于 研究撒哈拉以南非洲的HBV治疗策略。 指导的研究科学家发展奖将使我有机会获得 成为独立临床研究者的必要技能。我需要（1）模型中的特定培训 设计和验证； （2）推导临床和经济结果数据； （3）设计和 执行成本效益分析。我设计了一个教学课程来解决每个 这些培训目标。我还组建了一个由导师和合作者组成的多学科团队 致力于成功实现目标的方法论和/或内容专业知识 提议。到颁奖期结束时，我将设计并验证了一个新颖的HBV模拟 模型，通过来自撒哈拉以南非洲以下的临床和经济数据填充模型，并使用了 模型进行高影响成本效益分析，有可能引导HBV 整个大陆的管理。