Hepatitis C transmission and treatment as prevention - The role of the injecting network

摘要: Abstract Background The hepatitis C virus (HCV) epidemic is a major health issue; in most developed countries it driven by people who inject drugs (PWID). Injecting networks powerfully influence HCV transmission. In this paper we provide an overview of 10 years research into injecting and HCV, culminating network-based approach to provision direct-acting antiviral therapy. Methods Between 2005 2010 followed cohort 413 PWID, measuring incidence, prevalence risk, including network-related factors. We individual-based transmission model, using simulate the spread through empirical social network PWID. addition, created empirically grounded model relationships exponential random graph models (ERGMs), allowing simulation realistic for investigating treatment intervention strategies. Our work modelling underpins TAP Study, which examining feasibility community-based PWID with DAAs. Results observed incidence rates primary infection reinfection 12.8 per 100 person-years (PY) (95%CI: 7.7–20.0) 28.8 PY 15.0–55.4), respectively, determined that clusters correlated reported relationships. Transmission showed provided some protective effect, slowing compared fully connected, homogenous population. ERGMs revealed treating all their contacts was effective strategy targeting infected least effective. Conclusion Networks-based approaches greatly increase understanding will inform implementation as prevention