Prioritising Hepatitis C treatment in people with multiple injecting partners maximises prevention: a real-world network study
Prioritising Hepatitis C treatment in people with multiple injecting partners maximises prevention: a real-world network study
Objective: To describe an injecting network of PWID living in an isolated community on the Isle of Wight (UK) and the results of a agent-based simulation, testing the effect of Hepatitis C (HCV) treatment on transmission. Method: People who inject drugs (PWID) were identified via respondent driven sampling and recruited to a network and bio-behavioural survey. The injecting network they described formed the baseline population and potential transmission pathways in an agent-based simulation of HCV transmission and the effects of treatment over 12 months. Results: On average each PWID had 2.6 injecting partners (range 0–14) and 137 were connected into a single component. HCV in the network was associated with a higher proportion of positive injecting partners (p = 0.003) and increasing age (p = 0.011). The treatment of well-connected PWID led to significantly fewer new infections of HCV than treating at random (10 vs. 7, p<0.001). In all scenarios less than one individual was re-infected. Conclusion: In our model the preferential treatment of well-connected PWID maximised treatment as prevention. In the real-world setting, targeting treatment to actively injecting PWID, with multiple injecting partners may therefore represent the most efficient elimination strategy for HCV.
Computer simulation, Directly acting antivirals, Disease transmission, infectious, Drug users, Hepatitis C, Injecting network
225-231
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Meskarian, Rudabeh
932d1dac-784b-4f24-bdda-5ea34a16d8a2
Van Der Heijden, Peter
85157917-3b33-4683-81be-713f987fd612
Grellier, Leonie
5b353bf7-3bab-4510-8195-d5c9433b9f01
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Khakoo, Salim
6c16d2f5-ae80-4d9b-9100-6bfb34ad0273
February 2020
Buchanan, Ryan
9499f713-f684-4046-be29-83cd9d6f834d
Meskarian, Rudabeh
932d1dac-784b-4f24-bdda-5ea34a16d8a2
Van Der Heijden, Peter
85157917-3b33-4683-81be-713f987fd612
Grellier, Leonie
5b353bf7-3bab-4510-8195-d5c9433b9f01
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Khakoo, Salim
6c16d2f5-ae80-4d9b-9100-6bfb34ad0273
Buchanan, Ryan, Meskarian, Rudabeh, Van Der Heijden, Peter, Grellier, Leonie, Parkes, Julie and Khakoo, Salim
(2020)
Prioritising Hepatitis C treatment in people with multiple injecting partners maximises prevention: a real-world network study.
Journal of Infection, 80 (2), .
(doi:10.1016/j.jinf.2019.12.010).
Abstract
Objective: To describe an injecting network of PWID living in an isolated community on the Isle of Wight (UK) and the results of a agent-based simulation, testing the effect of Hepatitis C (HCV) treatment on transmission. Method: People who inject drugs (PWID) were identified via respondent driven sampling and recruited to a network and bio-behavioural survey. The injecting network they described formed the baseline population and potential transmission pathways in an agent-based simulation of HCV transmission and the effects of treatment over 12 months. Results: On average each PWID had 2.6 injecting partners (range 0–14) and 137 were connected into a single component. HCV in the network was associated with a higher proportion of positive injecting partners (p = 0.003) and increasing age (p = 0.011). The treatment of well-connected PWID led to significantly fewer new infections of HCV than treating at random (10 vs. 7, p<0.001). In all scenarios less than one individual was re-infected. Conclusion: In our model the preferential treatment of well-connected PWID maximised treatment as prevention. In the real-world setting, targeting treatment to actively injecting PWID, with multiple injecting partners may therefore represent the most efficient elimination strategy for HCV.
Text
Buchanan_manuscript_inf
- Accepted Manuscript
More information
Accepted/In Press date: 23 December 2019
e-pub ahead of print date: 28 December 2019
Published date: February 2020
Additional Information:
Funding Information:
This study was conducted with support from a National Institute for Health Research (NIHR) PhD fellowship and a GILEAD research fellowship award.
Publisher Copyright:
© 2019
Keywords:
Computer simulation, Directly acting antivirals, Disease transmission, infectious, Drug users, Hepatitis C, Injecting network
Identifiers
Local EPrints ID: 436940
URI: http://eprints.soton.ac.uk/id/eprint/436940
ISSN: 0163-4453
PURE UUID: fac9aece-a3a2-474d-89ee-4b85f8e3c04b
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Date deposited: 14 Jan 2020 17:31
Last modified: 17 Mar 2024 05:12
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Contributors
Author:
Rudabeh Meskarian
Author:
Leonie Grellier
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