Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe

Hannah Fraser; Natasha Martin; Henrikki  Brummer-Korvenkontio; Patrizia  Carrieri; Olav Dalgard; John Dillon; David Goldberg; Sharon Hutchinson; Marie Jauffret-Roustide; Martin Kaberg; Amy Matser; Mojca Matičič; Håvard Midgard; Viktor Mravčík; Anne Øvrehus; Maria Prins; Jens Reimer; Geert Robaeys; Bernd Schulte; Daniela van Santen; Ruth Zimmermann; Peter Vickerman; Matthew Hickman

doi:10.1016/j.jhep.2017.10.010

Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe

Hannah Fraser, Natasha Martin, Henrikki Brummer-Korvenkontio, Patrizia Carrieri, Olav Dalgard, John Dillon, David Goldberg, Sharon Hutchinson, Marie Jauffret-Roustide, Martin Kaberg, Amy Matser, Mojca Matičič, Håvard Midgard, Viktor Mravčík, Anne Øvrehus, Maria Prins, Jens Reimer, Geert Robaeys, Bernd Schulte, Daniela van SantenRuth Zimmermann, Peter Vickerman, Matthew Hickman

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Abstract

Background: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical to eliminating HCV in Europe. We estimate impact of current and scaled-up HCV treatment with and without scaling-up opioid substitution therapy (OST) and needle and syringe programmes (NSP) across Europe over the next 10 years.

Methods: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST and NSP coverage from 11 European settings. We parameterized a HCV transmission model to setting-specific data that projects 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. Current treatment rates using new direct acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10 years in Czech Republic, Slovenia and Amsterdam. Doubling 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 100pyrs or less in 10 years. Moderate to substantial increases in current treatment rates are required to achieve the same impact elsewhere, from 1.4-3 times (Czech Republic/France), 5-17 times (France/Scotland/Hamburg/Norway/Denmark/Belgium/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: Scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.

Original language	English
Pages (from-to)	402-411
Journal	Journal of Hepatology
Volume	68
Issue number	3
Early online date	25 Oct 2017
DOIs	https://doi.org/10.1016/j.jhep.2017.10.010
Publication status	Published - 1 Mar 2018

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Professor Matt Hickman
- Matthew.Hickmanbristol.acuk
- Bristol Medical School (PHS) - Professor in Public Health and Epidemiology
- Bristol Population Health Science Institute
- Health Protection Research Unit (HPRU)
- Centre for Academic Mental Health
- Infection and Immunity
- Centre for Academic Primary Care
Person: Academic , Member, Group lead
Professor Peter T Vickerman
- Peter.Vickermanbristol.acuk
- Bristol Population Health Science Institute
- Health Protection Research Unit (HPRU)
- Bristol Medical School (PHS) - Professor of Infectious Disease Modelling
- Infection and Immunity
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Fraser, H., Martin, N., Brummer-Korvenkontio, H., Carrieri, P., Dalgard, O., Dillon, J., Goldberg, D., Hutchinson, S., Jauffret-Roustide, M., Kaberg, M., Matser, A., Matičič, M., Midgard, H., Mravčík, V., Øvrehus, A., Prins, M., Reimer, J., Robaeys, G., Schulte, B., ... Hickman, M. (2018). Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe. Journal of Hepatology, 68(3), 402-411. https://doi.org/10.1016/j.jhep.2017.10.010

@article{d0cfcb461f3144b6b5b641abc5e2cb64,

title = "Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe",

abstract = "Background: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical to eliminating HCV in Europe. We estimate impact of current and scaled-up HCV treatment with and without scaling-up opioid substitution therapy (OST) and needle and syringe programmes (NSP) across Europe over the next 10 years. Methods: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST and NSP coverage from 11 European settings. We parameterized a HCV transmission model to setting-specific data that projects 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. Current treatment rates using new direct acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10 years in Czech Republic, Slovenia and Amsterdam. Doubling 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 100pyrs or less in 10 years. Moderate to substantial increases in current treatment rates are required to achieve the same impact elsewhere, from 1.4-3 times (Czech Republic/France), 5-17 times (France/Scotland/Hamburg/Norway/Denmark/Belgium/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: Scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.",

author = "Hannah Fraser and Natasha Martin and Henrikki Brummer-Korvenkontio and Patrizia Carrieri and Olav Dalgard and John Dillon and David Goldberg and Sharon Hutchinson and Marie Jauffret-Roustide and Martin Kaberg and Amy Matser and Mojca Mati{\v c}i{\v c} and H{\aa}vard Midgard and Viktor Mrav{\v c}{\'i}k and Anne {\O}vrehus and Maria Prins and Jens Reimer and Geert Robaeys and Bernd Schulte and {van Santen}, Daniela and Ruth Zimmermann and Peter Vickerman and Matthew Hickman",

year = "2018",

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doi = "10.1016/j.jhep.2017.10.010",

language = "English",

volume = "68",

pages = "402--411",

journal = "Journal of Hepatology",

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Fraser, H , Martin, N, Brummer-Korvenkontio, H, Carrieri, P, Dalgard, O, Dillon, J, Goldberg, D, Hutchinson, S, Jauffret-Roustide, M, Kaberg, M, Matser, A, Matičič, M, Midgard, H, Mravčík, V, Øvrehus, A, Prins, M, Reimer, J, Robaeys, G, Schulte, B, van Santen, D, Zimmermann, R, Vickerman, P & Hickman, M 2018, 'Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe', Journal of Hepatology, vol. 68, no. 3, pp. 402-411. https://doi.org/10.1016/j.jhep.2017.10.010

TY - JOUR

T1 - Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe

AU - Fraser, Hannah

AU - Martin, Natasha

AU - Brummer-Korvenkontio, Henrikki

AU - Carrieri, Patrizia

AU - Dalgard, Olav

AU - Dillon, John

AU - Goldberg, David

AU - Hutchinson, Sharon

AU - Jauffret-Roustide, Marie

AU - Kaberg, Martin

AU - Matser, Amy

AU - Matičič, Mojca

AU - Midgard, Håvard

AU - Mravčík, Viktor

AU - Øvrehus, Anne

AU - Prins, Maria

AU - Reimer, Jens

AU - Robaeys, Geert

AU - Schulte, Bernd

AU - van Santen, Daniela

AU - Zimmermann, Ruth

AU - Vickerman, Peter

AU - Hickman, Matthew

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical to eliminating HCV in Europe. We estimate impact of current and scaled-up HCV treatment with and without scaling-up opioid substitution therapy (OST) and needle and syringe programmes (NSP) across Europe over the next 10 years. Methods: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST and NSP coverage from 11 European settings. We parameterized a HCV transmission model to setting-specific data that projects 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. Current treatment rates using new direct acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10 years in Czech Republic, Slovenia and Amsterdam. Doubling 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 100pyrs or less in 10 years. Moderate to substantial increases in current treatment rates are required to achieve the same impact elsewhere, from 1.4-3 times (Czech Republic/France), 5-17 times (France/Scotland/Hamburg/Norway/Denmark/Belgium/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: Scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.

AB - Background: Prevention of hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is critical to eliminating HCV in Europe. We estimate impact of current and scaled-up HCV treatment with and without scaling-up opioid substitution therapy (OST) and needle and syringe programmes (NSP) across Europe over the next 10 years. Methods: We collected data on PWID HCV treatment rates, PWID prevalence, HCV prevalence, OST and NSP coverage from 11 European settings. We parameterized a HCV transmission model to setting-specific data that projects 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. Current treatment rates using new direct acting antivirals (DAAs) may achieve observable reductions in chronic prevalence (38-63%) in 10 years in Czech Republic, Slovenia and Amsterdam. Doubling 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 100pyrs or less in 10 years. Moderate to substantial increases in current treatment rates are required to achieve the same impact elsewhere, from 1.4-3 times (Czech Republic/France), 5-17 times (France/Scotland/Hamburg/Norway/Denmark/Belgium/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: Scale-up of HCV treatment and other interventions is needed in most settings to minimise HCV transmission among PWID in Europe.

U2 - 10.1016/j.jhep.2017.10.010

DO - 10.1016/j.jhep.2017.10.010

M3 - Article (Academic Journal)

C2 - 29080808

SN - 0168-8278

VL - 68

SP - 402

EP - 411

JO - Journal of Hepatology

JF - Journal of Hepatology

IS - 3

ER -

Model projections on the impact of HCV treatment in the prevention of HCV transmission among people who inject drugs in Europe

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