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Treatment and primary prevention in people who inject drugs for chronic hepatitis C infection: is elimination possible in a high-prevalence setting?

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Title: Treatment and primary prevention in people who inject drugs for chronic hepatitis C infection: is elimination possible in a high-prevalence setting?
Authors: Gountas, Ilias, Sypsa, Vana, Anagnostou, Olga, Martin, Natasha, Vickerman, Peter, Kafetzopoulos, Evangelos, Hatzakis, Angelos
Source: Addiction. Jul2017, Vol. 112 Issue 7, p1290-1299. 10p. 1 Diagram, 1 Chart, 4 Graphs.
Subjects: Hepatitis C prevention, Antiviral agents, Intravenous drug abuse, Hepatitis C treatment, Preventive medicine, Therapeutics, Hepatitis C, Mathematical models, Disease relapse, Theory, Intravenous drug abusers, Predictive tests, Statistical models, Descriptive statistics
Geographic Terms: Greece
Abstract: Aims To project the impact of scaling-up oral anti-viral therapy and harm reduction on chronic hepatitis C (CHC) prevalence and incidence among people who inject drugs (PWID) in Greece, to estimate the relationship between required treatment levels and expansion of harm reduction programmes to achieve specific targets and to examine whether hepatitis C virus (HCV) elimination among PWID is possible in this high-prevalence setting. Design A dynamic discrete time, stochastic individual-based model was developed to simulate HCV transmission among PWID incorporating the effect of HCV treatment and harm reduction strategies, and allowing for re-infection following treatment. Setting/participants The population of 8300 PWID in Athens Metropolitan area. Measurements Reduction in HCV prevalence and incidence in 2030 compared with 2016. Findings Moderate expansion of HCV treatment (treating 4-8% of PWID/year), with a simultaneous increase of 2%/year in harm reduction coverage (from 44 to 72% coverage over 15 years), was projected to reduce CHC prevalence among PWID in Athens by 46.2-94.8% in 2030, compared with 2016. CHC prevalence would reduce to below 10% within the next 4-5 years if annual HCV treatment numbers were increased up to 16-20% PWID/year. The effect of harm reduction on incidence was more pronounced under lower treatment rates. Conclusions Based on theoretical model projections, scaled-up hepatitis C virus treatment and harm reduction interventions could achieve major reductions in hepatitis C virus incidence and prevalence among people who inject drugs in Athens, Greece by 2030. Chronic hepatitis C could be eliminated in the next 4-5 years by increasing treatment to more than 16% of people who inject drugs per year combined with moderate increases in harm reduction coverage. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Treatment and primary prevention in people who inject drugs for chronic hepatitis C infection: is elimination possible in a high-prevalence setting?
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  Data: <searchLink fieldCode="AR" term="%22Gountas%2C+Ilias%22">Gountas, Ilias</searchLink><br /><searchLink fieldCode="AR" term="%22Sypsa%2C+Vana%22">Sypsa, Vana</searchLink><br /><searchLink fieldCode="AR" term="%22Anagnostou%2C+Olga%22">Anagnostou, Olga</searchLink><br /><searchLink fieldCode="AR" term="%22Martin%2C+Natasha%22">Martin, Natasha</searchLink><br /><searchLink fieldCode="AR" term="%22Vickerman%2C+Peter%22">Vickerman, Peter</searchLink><br /><searchLink fieldCode="AR" term="%22Kafetzopoulos%2C+Evangelos%22">Kafetzopoulos, Evangelos</searchLink><br /><searchLink fieldCode="AR" term="%22Hatzakis%2C+Angelos%22">Hatzakis, Angelos</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Jul2017, Vol. 112 Issue 7, p1290-1299. 10p. 1 Diagram, 1 Chart, 4 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Hepatitis+C+prevention%22">Hepatitis C prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Antiviral+agents%22">Antiviral agents</searchLink><br /><searchLink fieldCode="DE" term="%22Intravenous+drug+abuse%22">Intravenous drug abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+treatment%22">Hepatitis C treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Preventive+medicine%22">Preventive medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C%22">Hepatitis C</searchLink><br /><searchLink fieldCode="DE" term="%22Mathematical+models%22">Mathematical models</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Theory%22">Theory</searchLink><br /><searchLink fieldCode="DE" term="%22Intravenous+drug+abusers%22">Intravenous drug abusers</searchLink><br /><searchLink fieldCode="DE" term="%22Predictive+tests%22">Predictive tests</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+models%22">Statistical models</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Greece%22">Greece</searchLink>
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  Data: Aims To project the impact of scaling-up oral anti-viral therapy and harm reduction on chronic hepatitis C (CHC) prevalence and incidence among people who inject drugs (PWID) in Greece, to estimate the relationship between required treatment levels and expansion of harm reduction programmes to achieve specific targets and to examine whether hepatitis C virus (HCV) elimination among PWID is possible in this high-prevalence setting. Design A dynamic discrete time, stochastic individual-based model was developed to simulate HCV transmission among PWID incorporating the effect of HCV treatment and harm reduction strategies, and allowing for re-infection following treatment. Setting/participants The population of 8300 PWID in Athens Metropolitan area. Measurements Reduction in HCV prevalence and incidence in 2030 compared with 2016. Findings Moderate expansion of HCV treatment (treating 4-8% of PWID/year), with a simultaneous increase of 2%/year in harm reduction coverage (from 44 to 72% coverage over 15 years), was projected to reduce CHC prevalence among PWID in Athens by 46.2-94.8% in 2030, compared with 2016. CHC prevalence would reduce to below 10% within the next 4-5 years if annual HCV treatment numbers were increased up to 16-20% PWID/year. The effect of harm reduction on incidence was more pronounced under lower treatment rates. Conclusions Based on theoretical model projections, scaled-up hepatitis C virus treatment and harm reduction interventions could achieve major reductions in hepatitis C virus incidence and prevalence among people who inject drugs in Athens, Greece by 2030. Chronic hepatitis C could be eliminated in the next 4-5 years by increasing treatment to more than 16% of people who inject drugs per year combined with moderate increases in harm reduction coverage. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/add.13764
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        Text: English
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        PageCount: 10
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    Subjects:
      – SubjectFull: Hepatitis C prevention
        Type: general
      – SubjectFull: Antiviral agents
        Type: general
      – SubjectFull: Intravenous drug abuse
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      – SubjectFull: Greece
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