Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure

Scientific Reports
Cornelia MetzigPeter J White

Abstract

Treatment as Prevention (TasP) using directly-acting antivirals has been advocated for Hepatitis C Virus (HCV) in people who inject drugs (PWID), but treatment is expensive and TasP's effectiveness is uncertain. Previous modelling has assumed a homogeneously-mixed population or a static network lacking turnover in the population and injecting partnerships. We developed a transmission-dynamic model on a dynamic network of injecting partnerships using data from survey of injecting behaviour carried out in London, UK. We studied transmission on a novel exponential-clustered network, as well as on two simpler networks for comparison, an exponential unclustered and a random network, and found that TasP's effectiveness differs markedly. With respect to an exponential-clustered network, the random network (and homogeneously-mixed population) overestimate TasP's effectiveness, whereas the exponential-unclustered network underestimates it. For all network types TasP's effectiveness depends on whether treated patients change risk behaviour, and on treatment coverage: higher coverage requires fewer total treatments for the same health gain. Whilst TasP can greatly reduce HCV prevalence, incidence of infection, and incidence of reinfection...Continue Reading

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Aug 23, 2018·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Lauren E CiprianoJeremy D Goldhaber-Fiebert
Jun 24, 2017·Expert Opinion on Pharmacotherapy·Vincent SorianoPablo Barreiro
Sep 3, 2020·The Journal of Infectious Diseases·Daniel WinetskyMatthew Scherer
Apr 11, 2018·Journal of the International AIDS Society·Anders BoydKarine Lacombe
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Dec 9, 2020·Entropy·Cornelia Metzig, Caroline Colijn
Nov 20, 2019·The International Journal on Drug Policy·Meghan BelleroseBenjamin P Linas

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R package igraph
TasP

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