In an extended network of people who inject drugs (PWID), successful hepatitis C virus (HCV) treatment as prevention should incorporate the baseline HCV prevalence and will achieve greatest benefit when coverage is expanded, a recent study found. 5 graph models were fit using 1,574 PWID in Hartford, CT. The effectiveness of 7 treatment-as-prevention strategies on reducing HCV prevalence over 10 years and 20 years was compared to no treatment. Researchers found:
- At the highest baseline HCV prevalence in PWID (85%), expansion of treatment coverage does not substantially reduce HCV prevalence for any treatment-as-prevention strategy.
- However, when baseline HCV prevalence is ≤60%, treating >120 individuals per 1,000 PWID per year would likely eliminate HCV within 10 years.
- Assigning treatment randomly to PWID is better than targeting those with the most injection partners.
Zelenev A, Li J, Mazhnaya A, Basu S, Altice FL. Hepatitis C virus treatment as prevention in an extended network of people who inject drugs in the USA: A modelling study. Lancet. 2018;18(2):215-224. doi:10.1016/S1473-3099(17)30676-X.
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HCV Infection Among Children & Young Persons, J Hepatol; ePub 2018 Nov 26; Modin, et al
HCV Patients with Limited Access to Antiviral Therapy, Dig Liver Dis; ePub 2018 Nov 29; Lens, et al
Progression in the Elimination of HCV Infection, PLoS One; ePub 2018 Dec 4; Juanbeltz, et al
Increased HCV Screening in Veteran Populations, Jt Comm J Qual Patient Saf; ePub 2018 Sep 25; Wray, et al