Hepatitis C virus treatment as prevention in an extended network of people who inject drugs in the USA: a modelling study

Zelenev, Alexei; Li, Jianghong; Mazhnaya, Alyona; Basu, Sanjay; Altice, Frederick L.

doi:10.1016/s1473-3099(17)30676-x

Cited by 85 publications

(59 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In difference to setting 1, targeted PHI were found to be less efficient than random in setting 2, although addition of PEI is equally beneficial in both settings. These findings are in concert with other studies on modeling PHI in outbreak settings (Bartlett et al, 2017; Zelenev et al, 2018). The difference can be explained by topological features of uninfected nodes.…”

Section: Discussionsupporting

confidence: 89%

Intelligent Network DisRuption Analysis (INDRA): A targeted strategy for efficient interruption of hepatitis C transmissions

Campo

Khudyakov

2018

Infection, Genetics and Evolution

View full text Add to dashboard Cite

Hepatitis C virus (HCV) infection is a global public health problem. The implementation of public health interventions (PHI) to control HCV infection could effectively interrupt HCV transmission. PHI targeting high-risk populations, e.g., people who inject drugs (PWID), are the most efficient but there is a lack of tools for prioritizing individuals within a high-risk community. Here, we present Intelligent Network DisRuption Analysis (INDRA), a targeted strategy for efficient interruption of hepatitis C transmissions. Using a large HCV transmission network among PWID in Indiana as an example, we compare effectiveness of random and targeted strategies in reducing the rate of HCV transmission in two settings: (1) long-established and (2) rapidly spreading infections (outbreak). Identification of high centrality for the network nodes co-infected with HIV or >1 HCV subtype indicates that the network structure properly represents the underlying contacts among PWID relevant to the transmission of these infections. Changes in the network’s global efficiency (GE) were used as a measure of the PHI effects. In setting 1, simulation experiments showed that a 50% GE reduction can be achieved by removing 11.2 times less nodes using targeted vs random strategies. A greater effect of targeted strategies on GE was consistently observed when networks were simulated: (1) with a varying degree of errors in node sampling and link assignment, and (2) at different levels of transmission reduction at affected nodes. In simulations considering a 10% removal of infected nodes, targeted strategies were ~2.8 times more effective than random in reducing incidence. Peer-education intervention (PEI) was modeled as a probabilistic distribution of actionable knowledge of safe injection practices from the affected node to adjacent nodes in the network. Addition of PEI to the models resulted in a 2–3 times greater reduction in incidence than from direct PHI alone. In setting 2, however, random direct PHI were ~3.2 times more effective in reducing incidence at the simulated conditions. Nevertheless, addition of PEI resulted in a ~1.7-fold greater efficiency of targeted PHI. In conclusion, targeted PHI facilitated by INDRA outperforms random strategies in decreasing circulation of long-established infections. Network-based PEI may amplify effects of PHI on incidence reduction in both settings.

show abstract

Section: Discussionsupporting

confidence: 89%

Intelligent Network DisRuption Analysis (INDRA): A targeted strategy for efficient interruption of hepatitis C transmissions

Campo

Khudyakov

2018

Infection, Genetics and Evolution

View full text Add to dashboard Cite

show abstract

“…Mother-to-child transmission of HCV results in some individuals entering the model chronically infected. This occurs at a rate dependent on the number of HCV-infected women of childbearing age (modelled as [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and their HIV co-infection prevalence 14 . Once infected, individuals either spontaneously clear their infection, and become susceptible again, or develop lifelong chronic infection.…”

Section: Model Descriptionmentioning

confidence: 99%

“…Another limitation of our analysis is that our deterministic models did not capture the network effects of how HCV transmits among PWID, which has been shown to be important for assessing the impact of interventions for HCV 33,34 . This paper is less concerned in this question, rather its main aim is to determine how the observed epidemic among PWID may contribute to overall levels of transmission in that country.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study

Trickey

Fraser

Lim

et al. 2019

The Lancet Gastroenterology & Hepatology

174

125

View full text Add to dashboard Cite

, +44 (0) 117 928 7383 Implications of all the available evidence This modelling indicates the substantial contribution that injecting drug use makes to the global HCV epidemic. For many settings, scaling up HCV prevention and treatment interventions for people who inject drugs, including needle and syringe provision and opioid substitution therapy, will be essential to meet World Health Organization 2030 elimination targets.

show abstract

“…The United States and the World Health Organization have established goals for elimination of hepatitis C virus (HCV) by 2030 (1,2). Cure of HCV improves patient related outcomes, reduces complications related to cirrhosis and liver cancer, and prevents ongoing virus transmission (3,4). The HCV care cascade identi es the essential steps of HCV care necessary to achieve cure.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of perceived barriers to hepatitis C care among people who did not attend appointments in the non-urban U.S. South

Sherbuk

Tabackman

McManus

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Most people diagnosed with Hepatitis C virus (HCV) have not linked to care, despite the availability of safe and effective treatment. We aimed to understand why people diagnosed with HCV have not pursued care in the non-urban southern United States. Methods: We conducted a survey and semi-structured interview with participants referred to an HCV clinic who did not attend an appointment between 2014 and 2018. Our clinic is located in a non-urban region of Virginia at a university hospital. Qualitative data collection was guided by the Health Belief Model (HBM). Data was analyzed using qualitative content analysis to identify key factors influencing patient perceptions regarding HCV and pursuit of care.Results: Over half of previously referred patients (N=200) could not be reached by phone. Eleven participants enrolled, including 7 men and 4 women. Based on survey responses, unreliable transportation, unstable housing, substance use, and lack of insurance were common. Participants demonstrated good knowledge of HCV disease, complications, and treatment. On qualitative analysis of semi-structured interviews, final themes emerged from within and between HBM constructs. Emerging themes influencing patient perceptions included (1) structural barriers, (2) stigma, (3) prior experiences of HCV disease and treatment, (4) discordance between the recognized severity of HCV and expected impacts on one’s own health, and (5) patient-provider relationship. Substance use was not identified to be a barrier to care.Conclusions: Participants perceived individual and structural barriers to linking to care. A strong HCV knowledge base was not sufficient to motivate pursuit of care. Efforts to improve linkage to care must address barriers at multiple levels, and system-level changes are needed. As the majority of previously referred patients could not be contacted by phone, current approaches to patient engagement are not effective for reaching these populations. Expansion of HCV care to primary care settings with an established patient-provider relationship or co-located treatment within substance use treatment programs may serve to increase access to HCV treatment.

show abstract

Hepatitis C virus treatment as prevention in an extended network of people who inject drugs in the USA: a modelling study

Abstract: National Institute on Drug Abuse.

Cited by 85 publications

References 29 publications

Intelligent Network DisRuption Analysis (INDRA): A targeted strategy for efficient interruption of hepatitis C transmissions

Intelligent Network DisRuption Analysis (INDRA): A targeted strategy for efficient interruption of hepatitis C transmissions

The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study

A qualitative study of perceived barriers to hepatitis C care among people who did not attend appointments in the non-urban U.S. South

Contact Info

Product

Resources

About