HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact
Year: 2014
Type: article
Study design: Observational Study
Abstract: Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence.
Source: Journal of Viral Hepatitis
DOI: 10.1111/jvh.12338
Institutions: University of Bristol, London School of Hygiene & Tropical Medicine, University of London, Queen Mary University of London, Blizard Institute, Pennine Acute Hospitals NHS Trust, Nottingham University Hospitals NHS Trust, Plymouth Hospital, University Hospitals Plymouth NHS Trust, University of Dundee, Glasgow Caledonian University, Health Protection Scotland, Public Health England, University of Nottingham, MRC Biostatistics Unit
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,610
Funders: Pfizer, Novartis, Roche, Gilead Sciences, AbbVie, Wellcome Trust, United Kingdom Clinical Research Collaboration, Llywodraeth Cymru, National Institute for Health Research Health Protection Research Unit, Cancer Research UK, National Institute for Health and Care Research, British Heart Foundation, University of Bristol, Public Health England, Medical Research Council, Economic and Social Research Council, Programme Development Grants, Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, National Institute on Drug Abuse, Janssen Biotech
Awards: G2395963644, DECIPHer: Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Interventions to reduce hepatitis C virus transmission amongst injecting drug users in England, G7725855688, G8061159278, Can HCV treatment be delivered to injecting drug users in order to reduce HCV transmission and prevalence in the population: an empirical demonstration and evaluation, Modeling Structural HIV Determinants in Substance Users and related populations
OpenAlex ID: W1964273353