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Open Access research with a European policy impact...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by Strathclyde researchers, including by researchers from the European Policies Research Centre (EPRC).

EPRC is a leading institute in Europe for comparative research on public policy, with a particular focus on regional development policies. Spanning 30 European countries, EPRC research programmes have a strong emphasis on applied research and knowledge exchange, including the provision of policy advice to EU institutions and national and sub-national government authorities throughout Europe.

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Can antiviral therapy for hepatitis C reduce the prevalence of HCV among injecting drug user populations? : a modeling analysis of its prevention utility

Martin, Natasha K and Vickerman, Peter and Foster, Graham R. and Hutchinson, Sharon and Goldberg, David J. and Hickman, Matthew (2011) Can antiviral therapy for hepatitis C reduce the prevalence of HCV among injecting drug user populations? : a modeling analysis of its prevention utility. Journal of Hepatology, 54 (6). pp. 1137-1144. ISSN 0168-8278

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Abstract

Hepatitis C virus antiviral treatment is effective for individual patients, but few active injecting drug users are treated. We considered the utility of antiviral treatment for primary prevention of hepatitis C. A hepatitis C transmission model amongst injecting drug users was developed, incorporating treatment (62.5% average sustained viral response) with no retreatment after initial treatment failure, potential re-infection for those cured, equal genotype setting (genotype 1: genotype 2/3) and no immunity. In addition, we examined scenarios with varied treatment response rates, immunity, or retreatment of treatment failures. In the baseline scenario, annually treating 10 infections per 1000 injecting drug users results in a relative decrease in hepatitis C prevalence over 10 years of 31%, 13% or 7% for baseline (untreated endemic chronic infection) prevalences of 20%, 40% or 60%, respectively. Sensitivity analyses show that: including the potential for immunity has minimal effect on the predictions; prevalence reductions remain even if SVR is assumed to be 25% lower among active IDU then current evidence suggests; retreatment of treatment failures does not alter the short-term (<5 year) projections, but does increase treatment gains within 20 years; hepatitis C free life years gained from treating active injecting drug users are projected to be higher than from treating non-injecting drug users for prevalences below 60%. Despite the possibility of re-infection, modest rates of hepatitis C treatment amongst active injecting drug users could effectively reduce transmission. Evaluating and extending strategies to treat hepatitis C among active injectors is warranted.