Historique
Article de Périodique
Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe (2018)
Auteur(s) :
FRASER, H. ;
MARTIN, N. K. ;
BRUMMER-KORVENKONTIO, H. ;
CARRIERI, P. ;
DALGARD, O. ;
DILLON, J. ;
GOLDBERG, D. ;
HUTCHINSON, S. ;
JAUFFRET-ROUSTIDE, M. ;
KABERG, M. ;
MATSER, A. A. ;
MATICIC, M. ;
MIDGARD, H. ;
MRAVCIK, V. ;
OVREHUS, A. ;
PRINS, M. ;
REIMER, J. ;
ROBAEYS, G. ;
SCHULTE, B. ;
VAN SANTEN, D. K. ;
ZIMMERMANN, R. ;
VICKERMAN, P. ;
HICKMAN, M.
Année
2018
Page(s) :
402-411
Langue(s) :
Anglais
Refs biblio. :
49
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus mots-clés
PRODUIT ILLICITE
;
HEPATITE
;
USAGER
;
INJECTION
;
TRAITEMENT
;
PREVENTION
;
PREVALENCE
;
MODELE
;
INCIDENCE
Note générale :
Editorial: Achieving hepatitis C elimination in Europe - To treatment scale-up and beyond. Hellard M., Scott N., Sacks-Davis R., Pedrana A., p. 383-385.
Résumé :
BACKGROUND & AIMS: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical for eliminating HCV in Europe. We estimated the impact of current and scaled-up HCV treatment with and without scaling up opioid substitution therapy (OST) and needle and syringe programmes (NSPs) across Europe over the next 10years.
METHODS: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST, and NSP coverage from 11 European settings. We parameterised an HCV transmission model to setting-specific data that project chronic HCV prevalence and incidence among PWID.
RESULTS: At baseline, chronic HCV prevalence varied from <25% (Slovenia/Czech Republic) to >55% (Finland/Sweden), and <2% (Amsterdam/Hamburg/Norway/Denmark/Sweden) to 5% (Slovenia/Czech Republic) of chronically infected PWID were treated annually. The current treatment rates using new direct-acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10years in Czech Republic, Slovenia, and Amsterdam. Doubling the HCV treatment rates will reduce prevalence in other sites (12-24%; Belgium/Denmark/Hamburg/Norway/Scotland), but is unlikely to reduce prevalence in Sweden and Finland. Scaling-up OST and NSP to 80% coverage with current treatment rates using DAAs could achieve observable reductions in HCV prevalence (18-79%) in all sites. Using DAAs, Slovenia and Amsterdam are projected to reduce incidence to 2 per 100 person years or less in 10years. Moderate to substantial increases in the current treatment rates are required to achieve the same impact elsewhere, from 1.4 to 3 times (Czech Republic and France), 5-17 times (France, Scotland, Hamburg, Norway, Denmark, Belgium, and Sweden), to 200 times (Finland). Scaling-up OST and NSP coverage to 80% in all sites reduces treatment scale-up needed by 20-80%.
CONCLUSIONS: The scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.
LAY SUMMARY: Measuring the amount of HCV in the population of PWID is uncertain. To reduce HCV infection to minimal levels in Europe will require scale-up of both HCV treatment and other interventions that reduce injecting risk (especially OST and provision of sterile injecting equipment).
Highlights:
Chronic HCV prevalence and treatment rates among PWID vary widely across Europe.
HCV treatment scale-up is required in most sites to reduce HCV transmission.
Increasing OST/NSP coverage enhances HCV treatment prevention benefit.
METHODS: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST, and NSP coverage from 11 European settings. We parameterised an HCV transmission model to setting-specific data that project chronic HCV prevalence and incidence among PWID.
RESULTS: At baseline, chronic HCV prevalence varied from <25% (Slovenia/Czech Republic) to >55% (Finland/Sweden), and <2% (Amsterdam/Hamburg/Norway/Denmark/Sweden) to 5% (Slovenia/Czech Republic) of chronically infected PWID were treated annually. The current treatment rates using new direct-acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10years in Czech Republic, Slovenia, and Amsterdam. Doubling the HCV treatment rates will reduce prevalence in other sites (12-24%; Belgium/Denmark/Hamburg/Norway/Scotland), but is unlikely to reduce prevalence in Sweden and Finland. Scaling-up OST and NSP to 80% coverage with current treatment rates using DAAs could achieve observable reductions in HCV prevalence (18-79%) in all sites. Using DAAs, Slovenia and Amsterdam are projected to reduce incidence to 2 per 100 person years or less in 10years. Moderate to substantial increases in the current treatment rates are required to achieve the same impact elsewhere, from 1.4 to 3 times (Czech Republic and France), 5-17 times (France, Scotland, Hamburg, Norway, Denmark, Belgium, and Sweden), to 200 times (Finland). Scaling-up OST and NSP coverage to 80% in all sites reduces treatment scale-up needed by 20-80%.
CONCLUSIONS: The scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.
LAY SUMMARY: Measuring the amount of HCV in the population of PWID is uncertain. To reduce HCV infection to minimal levels in Europe will require scale-up of both HCV treatment and other interventions that reduce injecting risk (especially OST and provision of sterile injecting equipment).
Highlights:
Chronic HCV prevalence and treatment rates among PWID vary widely across Europe.
HCV treatment scale-up is required in most sites to reduce HCV transmission.
Increasing OST/NSP coverage enhances HCV treatment prevention benefit.
Affiliation :
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Autre(s) lien(s) :
Editorial