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

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 net...

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Autores principales:	Cornelia Metzig, Julian Surey, Marie Francis, Jim Conneely, Ibrahim Abubakar, Peter J. White
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/016aab2e9a1f4b34a540f3f195bb053d
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spelling	oai:doaj.org-article:016aab2e9a1f4b34a540f3f195bb053d2021-12-02T12:32:29ZImpact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure10.1038/s41598-017-01862-62045-2322https://doaj.org/article/016aab2e9a1f4b34a540f3f195bb053d2017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01862-6https://doaj.org/toc/2045-2322Abstract 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 in PWID, assessment of TasP’s effectiveness needs to take account of the injecting-partnership network structure and post-treatment behaviour change, and further empirical study is required.Cornelia MetzigJulian SureyMarie FrancisJim ConneelyIbrahim AbubakarPeter J. WhiteNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-13 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Cornelia Metzig Julian Surey Marie Francis Jim Conneely Ibrahim Abubakar Peter J. White Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
description	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 in PWID, assessment of TasP’s effectiveness needs to take account of the injecting-partnership network structure and post-treatment behaviour change, and further empirical study is required.
format	article
author	Cornelia Metzig Julian Surey Marie Francis Jim Conneely Ibrahim Abubakar Peter J. White
author_facet	Cornelia Metzig Julian Surey Marie Francis Jim Conneely Ibrahim Abubakar Peter J. White
author_sort	Cornelia Metzig
title	Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
title_short	Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
title_full	Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
title_fullStr	Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
title_full_unstemmed	Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure
title_sort	impact of hepatitis c treatment as prevention for people who inject drugs is sensitive to contact network structure
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/016aab2e9a1f4b34a540f3f195bb053d
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Impact of Hepatitis C Treatment as Prevention for People Who Inject Drugs is sensitive to contact network structure

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