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Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe
H. Fraser, NK. Martin, H. Brummer-Korvenkontio, P. Carrieri, O. Dalgard, J. Dillon, D. Goldberg, S. Hutchinson, M. Jauffret-Roustide, M. Kåberg, AA. Matser, M. Matičič, H. Midgard, V. Mravcik, A. Øvrehus, M. Prins, J. Reimer, G. Robaeys, B....
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
P30 AI036214
NIAID NIH HHS - United States
R01 DA037773
NIDA NIH HHS - United States
RP-DG-0610-10055
Department of Health - United Kingdom
- MeSH
- antivirové látky terapeutické užití MeSH
- chronická hepatitida C * farmakoterapie epidemiologie prevence a kontrola MeSH
- incidence MeSH
- intravenózní abúzus drog * komplikace epidemiologie prevence a kontrola MeSH
- lidé MeSH
- odhad potřeb MeSH
- opiátová substituční terapie metody MeSH
- přenos infekční nemoci prevence a kontrola statistika a číselné údaje MeSH
- prevalence MeSH
- programy výměny jehel a stříkaček metody organizace a řízení MeSH
- teoretické modely MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Evropa MeSH
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).
Academic Medical Centre University of Amsterdam Amsterdam The Netherlands
Akershus University Hospital Lørenskog Norway
Charles University and General University Hospital Prague Prague Czech Republic
Division of Global Public Health University of California San Diego San Diego CA USA
French Institute for Public Health Surveillance St Maurice France
Glasgow Caledonian University Glasgow Scotland UK
Hasselt University Diepenbeek Belgium
Health Protection Scotland Glasgow Scotland UK
National Institute for Health and Welfare Helsinki Finland
National Institute of Mental Health Klecany Czech Republic
National Monitoring Centre for Drugs and Drug Addiction Prague Czech Republic
Odense University Hospital Odense Denmark
ORS PACA Observatoire Régional de la Santé Provence Alpes Côte d'Azur Marseille France
Population Health Sciences Bristol Medical School University of Bristol Bristol UK
Public Health Service of Amsterdam Amsterdam The Netherlands
Robert Koch Institute Berlin Germany
University Hospital Leuven Leuven Belgium
University Medical Center Utrecht Utrecht The Netherlands
University Medical Centre Ljubljana Ljubljana Slovenia
University of Dundee Dundee Scotland UK
University of Hamburg Hamburg Germany
University of Ljubljana Ljubljana Slovenia
Citace poskytuje Crossref.org
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- $a Fraser, Hannah $u Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: hannah.fraser@bristol.ac.uk.
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- $a Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe / $c H. Fraser, NK. Martin, H. Brummer-Korvenkontio, P. Carrieri, O. Dalgard, J. Dillon, D. Goldberg, S. Hutchinson, M. Jauffret-Roustide, M. Kåberg, AA. Matser, M. Matičič, H. Midgard, V. Mravcik, A. Øvrehus, M. Prins, J. Reimer, G. Robaeys, B. Schulte, DK. van Santen, R. Zimmermann, P. Vickerman, M. Hickman,
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- $a 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).
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