Scaling-up Hepatitis C Prevention and Treatment Interventions for Achieving Elimination in the United States - a Rural and Urban Comparison.

Scaling-up Hepatitis C Prevention and Treatment Interventions for Achieving Elimination in the United States - a Rural and Urban Comparison. Am J Epidemiol. 2019 May 31;: Authors: Fraser H, Vellozzi C, Hoerger TJ, Evans JL, Kral AH, Havens J, Young AM, Stone J, Handanagic S, Hariri S, Barbosa C, Hickman M, Leib A, Martin NK, Nerlander L, Raymond HF, Page K, Zibbell J, Ward JW, Vickerman P Abstract In the U.S. Hepatitis C virus (HCV) transmission is increasing among people who inject drugs (PWID). Many regions have insufficient prevention intervention coverage. Using modelling, we investigate the impact of scaling-up prevention and treatment interventions on HCV transmission among PWID in Perry County, Kentucky (PC), and San Francisco, California (SF), where HCV sero-prevalence among PWID is >50%. A greater proportion of PWID access medication-assisted treatment (MAT) or syringe service programs (SSP) in urban SF (established community) than rural PC (young, expanding community). We model the proportion of HCV-infected PWID needing HCV-treatment annually to reduce HCV-incidence by 90% by 2030, with and without MAT scale-up (50% coverage, both settings) and SSP scale-up (PC only) from 2017. With current MAT&SSP coverage during 2017-2030, HCV-incidence will increase in PC (21.3 to 22.6 per 100 person-years (/100pyrs)) and decrease in SF (12.9 to 11.9/100pyrs). With concurrent MAT&SSP scale-up, 5%/year of HCV-infected PWID nee...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research