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Title: | Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe | Authors: | Fraser, Hannah Martin, Natasha K. Brummer-Korvenkontio, Henrikki Carrieri, Patrizia Dalgard, Olav Dillon, John Goldberg, David Hutchinson, Sharon Jauffret-Roustide, Marie Kaberg, Martin Matser, Amy A. Maticic, Mojca Midgard, Havard Mravcik, Viktor Ovrehus, Anne Prins, Maria Reimer, Jens ROBAEYS, Geert Schulte, Bernd van Santen, Daniela K. Zimmermann, Ruth Vickerman, Peter Hickman, Matthew |
Issue Date: | 2018 | Publisher: | ELSEVIER SCIENCE BV | Source: | JOURNAL OF HEPATOLOGY, 68(3), p. 402-411 | Abstract: | Background & Aims: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical for eliminating HCV in Europe. We estimated the impact of current and scaled-up HCV treatment with and without scaling up opioid substitution therapy (OST) and needle and syringe programmes (NSPs) across Europe over the next 10 years. Methods: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST, and NSP coverage from 11 European settings. We parameterised an HCV transmission model to setting-specific data that project chronic HCV prevalence and incidence among PWID. Results: At baseline, chronic HCV prevalence varied from <25% (Slovenia/Czech Republic) to >55% (Finland/Sweden), and <2% (Amsterdam/Hamburg/Norway/Denmark/Sweden) to 5% (Slovenia/Czech Republic) of chronically infected PWID were treated annually. The current treatment rates using new direct-acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10 years in Czech Republic, Slovenia, and Amsterdam. Doubling the HCV treatment rates will reduce prevalence in other sites (12-24%; Belgium/Denmark/Hamburg/Norway/Scotland), but is unlikely to reduce prevalence in Sweden and Finland. Scaling-up OST and NSP to 80% coverage with current treatment rates using DAAs could achieve observable reductions in HCV prevalence (18-79%) in all sites. Using DAAs, Slovenia and Amsterdam are projected to reduce incidence to 2 per 100 person years or less in 10 years. Moderate to substantial increases in the current treatment rates are required to achieve the same impact elsewhere, from 1.4 to 3 times (Czech Republic and France), 5-17 times (France, Scotland, Hamburg, Norway, Denmark, Belgium, and Sweden), to 200 times (Finland). Scaling-up OST and NSP coverage to 80% in all sites reduces treatment scale-up needed by 20-80%. Conclusions: The scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe. Lay summary: Measuring the amount of HCV in the population of PWID is uncertain. To reduce HCV infection to minimal levels in Europe will require scale-up of both HCV treatment and other interventions that reduce injecting risk (especially OST and provision of sterile injecting equipment). (C) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. | Notes: | [Fraser, Hannah; Martin, Natasha K.; Vickerman, Peter; Hickman, Matthew] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England. [Martin, Natasha K.] Univ Calif San Diego, Div Global Publ Hlth, San Diego, CA USA. [Brummer-Korvenkontio, Henrikki] Natl Inst Hlth & Welf, Helsinki, Finland. [Carrieri, Patrizia] Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France. [Carrieri, Patrizia] ORS PACA, Observ Reg Sante Provence Alpes Cote dAzur, Marseille, France. [Dalgard, Olav; Midgard, Havard] Univ Oslo, Oslo, Norway. [Dalgard, Olav] Akershus Univ Hosp, Lorenskog, Norway. [Dillon, John] Univ Dundee, Dundee, Scotland. [Goldberg, David; Hutchinson, Sharon] Hlth Protect Scotland, Glasgow, Lanark, Scotland. [Hutchinson, Sharon] Glasgow Caledonian Univ, Glasgow, Lanark, Scotland. [Jauffret-Roustide, Marie] French Inst Publ Hlth Surveillance, St Maurice, France. [Jauffret-Roustide, Marie] Paris Descartes Univ, Inserm U988, UMR CNRS 8211, EHESS,CERMES3, Paris, France. [Kaberg, Martin] Karolinska Univ Hosp, Dept Med, Div Infect Dis, Karolinska Inst, Stockholm, Sweden. [Matser, Amy A.; Prins, Maria; van Santen, Daniela K.] Publ Hlth Serv Amsterdam, Amsterdam, Netherlands. [Matser, Amy A.] Univ Med Ctr Utrecht, Utrecht, Netherlands. [Maticic, Mojca] Univ Ljubljana, Ljubljana, Slovenia. [Maticic, Mojca] Univ Med Ctr Ljubljana, Ljubljana, Slovenia. [Mravcik, Viktor] Natl Monitoring Ctr Drugs & Drug Addict, Prague, Czech Republic. [Mravcik, Viktor] Charles Univ Prague, Prague, Czech Republic. [Mravcik, Viktor] Gen Univ Hosp Prague, Prague, Czech Republic. [Mravcik, Viktor] Natl Inst Mental Hlth, Klecany, Czech Republic. [Ovrehus, Anne] Odense Univ Hosp, Odense, Denmark. [Prins, Maria] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands. [Reimer, Jens] HealthNorth, Bremen, Germany. [Reimer, Jens; Schulte, Bernd] Univ Hamburg, Hamburg, Germany. [Robaeys, Geert] Ziekenhuis Oost Limburg, Genk, Belgium. [Robaeys, Geert] Hasselt Univ, Diepenbeek, Belgium. [Robaeys, Geert] Univ Hosp Leuven, Leuven, Belgium. [Zimmermann, Ruth] Robert Koch Inst, Berlin, Germany. | Keywords: | Hepatitis C; PWID; Opioid substitution therapy; Direct-acting antivirals;Hepatitis C; PWID; Opioid substitution therapy; Direct-acting antivirals | Document URI: | http://hdl.handle.net/1942/27320 | ISSN: | 0168-8278 | e-ISSN: | 1600-0641 | DOI: | 10.1016/j.jhep.2017.10.010 | ISI #: | 000425279100008 | Rights: | Copyright 2017 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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