Prioritising Hepatitis C treatment in people with multiple injecting partners maximises prevention: A real-world network study - 05/02/20
, Rudabeh Meskarian b , Peter van der Heijden c , Leonie Grellier d , Julie Parkes a , Salim I Khakoo e Highlights |
• | Drug injecting networks resemble other naturally occurring human networks. |
• | Hepatitis c (HCV) is clustered within drug injecting networks. |
• | HCV transmission is prevented by treatment of nodes with large networks. |
• | The risks of HCV primary infection outweight risks of reinfection. |
Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatitis C, Injecting network, Drug users, Disease transmission, infectious, Computer simulation, Directly acting antivirals
Plan
Vol 80 - N° 2
P. 225-231 - février 2020 Retour au numéro
Article précédent
- Hepatitis B virus-associated B-cell non-Hodgkin lymphoma in non-endemic areas in Western Europe: Clinical characteristics and prognosis
- Marine Lemaitre, Pauline Brice, Marco Frigeni, Olivier Hermine, Luca Arcaini, Catherine Thieblemont, Caroline Besson
- The updated analysis of African swine fever virus genomes: Two novel genotypes are identified
- Chao Ye, Xingping Wu, Tingting Chen, Qingyuan Huang, Rendong Fang, Tongqing An
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?