Titre : | Can needle and syringe programmes and opiate substitution therapy achieve substantial reductions in hepatitis C virus prevalence? Model projections for different epidemic settings (2012) |
Auteurs : | P. VICKERMAN ; N. MARTIN ; K. TURNER ; M. HICKMAN |
Type de document : | Article : Périodique |
Dans : | Addiction (Vol.107, n°11, November 2012) |
Article en page(s) : | 1984-1995 |
Note générale : | Commentary: Reducing hepatitis C virus among injection drug users through harm reduction programs. Smith-Spangler C.M., Asch S.M., p. 1996-1997. |
Langues: | Anglais |
Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
Mots-clés : |
Thésaurus géographique ROYAUME-UNIThésaurus mots-clés PROGRAMME ; ECHANGE DE SERINGUES ; TRAITEMENT DE MAINTENANCE ; SUBSTITUTION ; HEPATITE ; PREVALENCE ; REDUCTION DES RISQUES ET DES DOMMAGES ; MODELE STATISTIQUE |
Résumé : |
Aims: To investigate the impact of scaling-up opiate substitution therapy (OST) and high coverage needle and syringe programmes (100%NSP - obtaining more sterile syringes than you inject) on HCV prevalence among injecting drug users (IDUs).
Design: Hepatitis C virus HCV transmission modelling using UK estimates for effect of OST and 100%NSP on individual risk of HCV infection. Setting: Range of chronic HCV prevalent (20/40/60%) settings with no OST/100%NSP, and UK setting with 50% coverage of both OST and 100%NSP. Participants: Injecting drug users. Measurements: Decrease in HCV prevalence after 5-20 years due to scale-up of OST and 100%NSP to 20/40/60% coverage in no OST/100%NSP settings, or from 50% to 60/70/80% coverage in the UK setting. Findings: For 40% chronic HCV prevalence, scaling-up OST and 100%NSP from 0% to 20% coverage reduces HCV prevalence by 13% after 10 years. This increases to a 24/33% relative reduction at 40/60% coverage. Marginally less impact occurs in higher prevalence settings over 10 years, but this becomes more pronounced over time. In the United Kingdom, without current coverage levels of OST and 100%NSP the chronic HCV prevalence could be 65% instead of 40%. However, increasing OST and 100%NSP coverage further is unlikely to reduce chronic prevalence to less than 30% over 10 years unless coverage becomes >=80%. Conclusions: Scaling-up opiate substitution therapy and high coverage needle and syringe programmes can reduce hepatitis C prevalence among injecting drug users, but reductions can be modest and require long-term sustained intervention coverage. In high coverage settings, other interventions are needed to further decrease hepatitis C prevalence. In low coverage settings, sustained scale-up of both interventions is needed. |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 76 |
Affiliation : | London School of Hygiene and Tropical Medicine, London, UK |
Cote : | Abonnement |
Lien : | http://dx.doi.org/10.1111/j.1360-0443.2012.03932.x |
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