Zelenev, Alexei and Li, Jianghong and Shea, Portia and Hecht, Robert and Altice, Frederick L. (2020) Modeling combination Hepatitis C virus treatment and prevention strategies in a network of people who inject drugs in the United States. Clinical Infectious Diseases, 72 (5). pp. 755-763. ISSN 1058-4838, DOI https://doi.org/10.1093/cid/ciaa142.
Full text not available from this repository.Abstract
BACKGROUND: Hepatitis C virus (HCV) treatment as prevention (TasP) strategies can contribute to HCV microelimination, yet complimentary interventions such as opioid agonist therapies (OAT) with methadone or buprenorphine and syringe services programs (SSPs) may improve the prevention impact. This modeling study estimates the impact of scaling up the combination of OAT and SSPs with HCV TasP in a network of people who inject drugs (PWID) in the United States. METHODS: Using empirical data from Hartford, Connecticut, we deployed a stochastic block model to simulate an injection network of 1574 PWID. We used a susceptible-infected model for HCV and human immunodeficiency virus to evaluate the effectiveness of several HCV TasP strategies, including in combination with OAT and SSP scale-up, over 20 years. RESULTS: At the highest HCV prevalence (75%), when OAT coverage is increased from 10% to 40%, combined with HCV treatment of 10% per year and SSP scale up to 40%, the time to achieve microelimination is reduced from 18.4 to 11.6 years. At the current HCV prevalence (60%), HCV TasP strategies as low as 10% coverage per year may achieve HCV microelimination within 10 years, with minimal impact from additional OAT scale-up. Strategies based on mass initial HCV treatment (50 per 100 PWID the first year followed by 5 per 100 PWID thereafter) were most effective in settings with HCV prevalence of 60% or lower. CONCLUSIONS: Scale-up of HCV TasP is the most effective strategy for microelimination of HCV. OAT scale-up, however, scale-up may be synergistic toward achieving microelimination goals when HCV prevalence exceeds 60% and when HCV treatment coverage is 10 per 100 PWID per year or lower. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Additional Information: | Altice, F.L. Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. |
| Uncontrolled Keywords: | HCV treatment; injection networks; opioid agonist therapies; people who inject drugs; syringe service program |
| Subjects: | R Medicine |
| Divisions: | Centre of Excellence for Research in AIDS (CERiA) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 21 Apr 2021 03:56 |
| Last Modified: | 21 Apr 2021 03:56 |
| URI: | http://eprints.um.edu.my/id/eprint/25880 |
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