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Impact of current and scaled‐up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings—what is required to achieve the WHO's HCV elimination targets?

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Title: Impact of current and scaled‐up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings—what is required to achieve the WHO's HCV elimination targets?
Authors: Ward, Zoe, Platt, Lucy, Sweeney, Sedona, Hope, Vivian D., Maher, Lisa, Hutchinson, Sharon, Palmateer, Norah, Smith, Josie, Craine, Noel, Taylor, Avril, Martin, Natasha, Ayres, Rachel, Dillon, John, Hickman, Matthew, Vickerman, Peter
Source: Addiction. Sep2018, Vol. 113 Issue 9, p1727-1738. 12p. 1 Diagram, 2 Charts, 3 Graphs.
Subjects: Hepatitis C prevention, Hepatitis C treatment, Intravenous drug abusers, Treatment effectiveness, Needle exchange programs, Drug therapy, Opioids, Diseases, World Health Organization, Disease prevalence, Infectious disease transmission, Hepatitis C risk factors, Hepatitis C transmission, Hepatitis C, Mathematical models, Theory, Human services programs
Geographic Terms: United Kingdom
Abstract: Abstract: Aims: To estimate the impact of existing high‐coverage needle and syringe provision (HCNSP, defined as obtaining more than one sterile needle and syringe per injection reported) and opioid substitution therapy (OST) on hepatitis C virus (HCV) transmission among people who inject drugs (PWID) in three UK settings and to determine required scale‐up of interventions, including HCV treatment, needed to reach the World Health Organization (WHO) target of reducing HCV incidence by 90% by 2030. Design: HCV transmission modelling using UK empirical estimates for effect of OST and/or HCNSP on individual risk of HCV acquisition. Setting and participants: Three UK cities with varying chronic HCV prevalence (Bristol 45%, Dundee 26%, Walsall 19%), OST (72–81%) and HCNSP coverage (28–56%). Measurements: Relative change in new HCV infections throughout 2016–30 if current interventions were stopped. Scale‐up of HCNSP, OST and HCV treatment required to achieve the WHO elimination target. Findings: Removing HCNSP or OST would increase the number of new HCV infections throughout 2016 to 2030 by 23–64 and 92–483%, respectively. Conversely, scaling‐up these interventions to 80% coverage could achieve a 29 or 49% reduction in Bristol and Walsall, respectively, whereas Dundee may achieve a 90% decrease in incidence with current levels of intervention because of existing high levels of HCV treatment (47–58 treatments per 1000 PWID). If OST and HCNSP are scaled‐up, Walsall and Bristol can achieve the same impact by treating 14 or 40 per 1000 PWID annually, respectively (currently two and nine treatments per 1000 PWID), while 18 and 43 treatments per 1000 PWID would be required if OST and HCNSP are not scaled‐up. Conclusions: Current opioid substitution therapy and high‐coverage needle and syringe provision coverage is averting substantial hepatitis C transmission in the United Kingdom. Maintaining this coverage while getting current drug injectors onto treatment can reduce incidence by 90% by 2030. [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: Impact of current and scaled‐up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings—what is required to achieve the WHO's HCV elimination targets?
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Sep2018, Vol. 113 Issue 9, p1727-1738. 12p. 1 Diagram, 2 Charts, 3 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Hepatitis+C+prevention%22">Hepatitis C prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+treatment%22">Hepatitis C treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Intravenous+drug+abusers%22">Intravenous drug abusers</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Needle+exchange+programs%22">Needle exchange programs</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+therapy%22">Drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Opioids%22">Opioids</searchLink><br /><searchLink fieldCode="DE" term="%22Diseases%22">Diseases</searchLink><br /><searchLink fieldCode="DE" term="%22World+Health+Organization%22">World Health Organization</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+prevalence%22">Disease prevalence</searchLink><br /><searchLink fieldCode="DE" term="%22Infectious+disease+transmission%22">Infectious disease transmission</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+risk+factors%22">Hepatitis C risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+transmission%22">Hepatitis C transmission</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="%22Theory%22">Theory</searchLink><br /><searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink>
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  Data: Abstract: Aims: To estimate the impact of existing high‐coverage needle and syringe provision (HCNSP, defined as obtaining more than one sterile needle and syringe per injection reported) and opioid substitution therapy (OST) on hepatitis C virus (HCV) transmission among people who inject drugs (PWID) in three UK settings and to determine required scale‐up of interventions, including HCV treatment, needed to reach the World Health Organization (WHO) target of reducing HCV incidence by 90% by 2030. Design: HCV transmission modelling using UK empirical estimates for effect of OST and/or HCNSP on individual risk of HCV acquisition. Setting and participants: Three UK cities with varying chronic HCV prevalence (Bristol 45%, Dundee 26%, Walsall 19%), OST (72–81%) and HCNSP coverage (28–56%). Measurements: Relative change in new HCV infections throughout 2016–30 if current interventions were stopped. Scale‐up of HCNSP, OST and HCV treatment required to achieve the WHO elimination target. Findings: Removing HCNSP or OST would increase the number of new HCV infections throughout 2016 to 2030 by 23–64 and 92–483%, respectively. Conversely, scaling‐up these interventions to 80% coverage could achieve a 29 or 49% reduction in Bristol and Walsall, respectively, whereas Dundee may achieve a 90% decrease in incidence with current levels of intervention because of existing high levels of HCV treatment (47–58 treatments per 1000 PWID). If OST and HCNSP are scaled‐up, Walsall and Bristol can achieve the same impact by treating 14 or 40 per 1000 PWID annually, respectively (currently two and nine treatments per 1000 PWID), while 18 and 43 treatments per 1000 PWID would be required if OST and HCNSP are not scaled‐up. Conclusions: Current opioid substitution therapy and high‐coverage needle and syringe provision coverage is averting substantial hepatitis C transmission in the United Kingdom. Maintaining this coverage while getting current drug injectors onto treatment can reduce incidence by 90% by 2030. [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.14217
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      – SubjectFull: World Health Organization
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