SCALING UP HEPATITIS C PREVENTION AND TREATMENT INTERVENTIONS FOR ACHIEVING ELIMINATION IN THE UNITED STATES: A RURAL AND URBAN COMPARISON (vol 188, pg 1539, 2019)

作     者：Fraser, H. Vellozzi, C. Hoerger, T. J. 

作者机构：Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom Correspondence to Dr. Hannah Fraser Population Health Sciences Bristol Medical School University of Bristol Oakfield House Oakfield Grove Bristol BS8 2BN United Kingdom (e-mail: hannah.fraser@bristol.ac.uk). Division of Medical Affairs Grady Health System Atlanta Georgia RTI International Research Triangle Park Raleigh North Carolina Institute for Global Health Sciences University of California San Francisco San Francisco California RTI International Research Triangle Park Raleigh North Carolina Center on Drug and Alcohol Research Department of Behavioral Science University of Kentucky College of Medicine Lexington Kentucky Center on Drug and Alcohol Research Department of Behavioral Science University of Kentucky College of Medicine Lexington Kentucky Department of Epidemiology University of Kentucky College of Public Health Lexington Kentucky Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta Georgia Division of Viral Hepatitis Centers for Disease Control and Prevention Atlanta Georgia RTI International Research Triangle Park Raleigh North Carolina Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom Department of Chemistry University of Colorado Denver Colorado Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom Division of Infectious Diseases and Global Public Health Department of Medicine University of California San Diego San Diego California Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta Georgia Center for Public Health Research Population Health Division San Francisco Department of Public Health San Francisco California Department of Internal Medicine School of Medicine University of New Mexico Health Sciences Center Albuquerque New Mexico RTI International Research Triangle Park Raleigh North Carolina Division of Viral Hepatitis Centers for Disease Control and Prevention Atlanta Georgia Coalition for Global Hepatitis Elimination Task Force for Global Health Decatur Georgia Population Health Sciences Bristol Medical School University of Bristol Bristol United Kingdom 

出 版 物：《AMERICAN JOURNAL OF EPIDEMIOLOGY》 (美国流行病学杂志)

年 卷 期：2019年第188卷第11期

页      面：2041-2041页

核心收录：

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

基　　金：National Institute on Drug Abuse (NIDA)  National Institutes of Health [R01DA033862] 

主　　题：direct-acting-antiviral HCV treatment hepatitis C virus medication-assisted treatment modeling people who inject drugs syringe service programs 

摘      要：In the United States, hepatitis C virus (HCV) transmission is rising among people who inject drugs (PWID). Many regions have insufficient prevention intervention coverage. Using modeling, we investigated the impact of scaling up prevention and treatment interventions on HCV transmission among PWID in Perry County, Kentucky, and San Francisco, California, where HCV seroprevalence among PWID is 50%. A greater proportion of PWID access medication-assisted treatment (MAT) or syringe service programs (SSP) in urban San Francisco (established community) than in rural Perry County (young, expanding community). We modeled 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 (Perry County only) from 2017. With current MAT and SSP coverage during 2017-2030, HCV incidence would increase in Perry County (from 21.3 to 22.6 per 100 person-years) and decrease in San Francisco (from 12.9 to 11.9 per 100 person-years). With concurrent MAT and SSP scale-up, 5% per year of HCV-infected PWID would need HCV treatment in Perry County to achieve incidence targets—13% per year without MAT and SSP scale-up. In San Francisco, a similar proportion would need HCV treatment (10% per year) irrespective of MAT scale-up. Reaching the same impact by 2025 would require increases in treatment rates of 45%-82%. Achievable provision of HCV treatment, alongside MAT and SSP scale-up (Perry County) and MAT scale-up (San Francisco), could reduce HCV incidence.