Evaluating the Prevention Benefit of HCV Treatment: Modeling the SToP-C Treatment as Prevention Study in Prisons.

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Aaron G LimPeter Vickerman

Abstract

Between 2014 and 2019, the SToP-C trial observed a halving in HCV incidence in four Australian prisons following scale-up of direct-acting antiviral (DAA) therapy. However, the contribution of HCV treatment to this decline is unclear because the study did not have a control group. We used modeling to consider this question. We parameterized and calibrated a dynamic model of HCV transmission in prisons to data from each SToP-C prison on incarceration dynamics, injecting drug use, HCV prevalence trends among prison entrants, baseline HCV incidence before treatment scale-up, and subsequent HCV treatment scale-up. The model projected the decrease in HCV incidence resulting from increases in HCV treatment and other effects. We assessed whether the model agreed better with observed reductions in HCV incidence overall and by prison if we included HCV treatment scale-up, and its prevention benefits, or did not. The model estimated how much of the observed decrease in HCV incidence was attributable to HCV treatment in prison. The model projected a decrease in HCV incidence of 48.5% (95% uncertainty interval [UI], 41.9-54.1) following treatment scale-up across the four prisons, agreeing with the observed HCV incidence decrease (47.6%; 95...Continue Reading

References

Mar 19, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Sarah LarneyLouisa Degenhardt
Feb 13, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Natasha K MartinMatthew Hickman
Dec 1, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anne BoerekampsBart J Rijnders
Dec 24, 2017·Journal of Viral Hepatitis·B HajarizadehG J Dore
Jan 26, 2018·The International Journal on Drug Policy·Evan B CunninghamUNKNOWN HITS-p Investigators
Sep 25, 2018·The Lancet. Gastroenterology & Hepatology·Behzad HajarizadehJason Grebely
Aug 8, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Dominique L BraunJan S Fehr
May 10, 2021·The Lancet. Gastroenterology & Hepatology·Behzad HajarizadehUNKNOWN SToP-C study group

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