Hepatitis C treatment as prevention of viral transmission and liver-related morbidity in persons who inject drugs.

摘要: Hepatitis C virus (HCV) seroprevalence remains high in people who inject drug (PWID) populations, often above 60%. Highly effective direct-acting antiviral (DAA) regimens (90% efficacy) are becoming available for HCV treatment. This therapeutic revolution raises the possibility of eliminating from this population. However, this, an cascade care is required. In context DAA therapies, we used a dynamic individual-based model including PWID social network to simulate impact improved testing, linkage care, and adherence treatment, modified treatment recommendation on transmission morbidity France. Under current incidence with initiated at fibrosis stage ≥F2, prevalence decreased 42.8% 24.9% (95% confidence interval: 24.8-24.9) after 10 years. Changing initiation criteria treat F0 was only intervention leading substantial additional decrease prevalence, which fell 11.6% CI: 11.6-11.7) Combining change 7.0% 7.0-7.1) years avoided 15% 14-17) 29% 28-30) cirrhosis complications over 40 years, respectively. Conclusions: Major decreases prevalent infections occur when early stages fibrosis, suggesting that systematic PWID, where high, would be beneficial. elimination within next will difficult achieve using alone, even highly care. (Hepatology 2016;63:1090–1101)