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Title: Mitigating the burden of hepatitis C virus among people who inject drugs in Belgium
Authors: Mathei, Catharina
Bourgeois, Stefan
Blach, Sarah
Brixko, Christian
Mulkay, Jean-Pierre
Razavi, Homie
Issue Date: 2016
Abstract: Background and Aims : In 2010, there were an estimated 10 100 PWID in Belgium and 43% (34%-57%) were HCV infected. Understanding HCV transmission dynamics in high-risk populations and assessing the potential impact of improved HCV treatment strategies requires robust epidemiological data and mathematical modeling. Methods : HCV transmission was modeled using cohorts to track HCV incidence and prevalence among active PWID in the general PWID population, OST and NSP. Model assumptions were derived from published literature and expert consensus. The relative impact of increasing the number of PWID treated with new oral DAAs was considered. Results : If the current transmission paradigm continues, there will be 2645 HCV-infected PWID in 2030. Annually treating 30 (1% of 2015 population) or 120 (4% of 2015 population) HCV-infected PWID with oral DAAs will result in 5% and 25% reductions, respectively, in HCV-infected PWID by 2030. Treating 370 PWID annually (12.5% of 2015 population) will result in a > 90% reduction by 2030. Conclusion : Treating a small number of PWID can result in substantial reduction in HCV prevalence in this population; however, high levels of treatment are necessary to reduce the viral pool and thus the risk of secondary infections. This analysis supports implementation of a screening and treatment strategy among PWID when combined with an expansion of harm reduction programs.
Notes: [Mathei, Catharina] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Kapucijnenvoer 33 Blok J Bus 7001, B-3000 Leuven, Belgium. [Bourgeois, Stefan] ZNA Campus Stuivenberg, Antwerp, Belgium. [Blach, Sarah; Razavi, Homie] Ctr Dis Anal, Louisville, CO USA. [Brixko, Christian] CHR Citadelle, Dept Gastroenterol & Digest Oncol, Liege, Belgium. [Mulkay, Jean-Pierre] CHU St Pierre, Hepatogastroenterol, Brussels, Belgium. [Robaeys, Geert] Ziekenhuis Oost Limburg, Dept Gastroenterol & Hepatol, Genk, Belgium. [Robaeys, Geert] Hasselt Univ, Fac Med & Life Sci, Diepenbeek, Belgium. [Robaeys, Geert] UZ Leuven, Dept Hepatol, Leuven, Belgium.
Keywords: hepatitis C; pwid; injecting drug users; transmission; incidence; prevalence;hepatitis C; pwid; injecting drug users; transmission; incidence; prevalence
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ISSN: 0001-5644
ISI #: 000384746300010
Rights: © Acta Gastro-Enterologica Belgica.
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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