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3. Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis

Author

Artenie, Adelina, Stone, Jack, Fraser, Hannah, Stewart, Daniel, Arum, Chiedozie, Lim, Aaron G, McNaughton, Anna L, Trickey, Adam, Ward, Zoe, Abramovitz, Daniela, Alary, Michel, Astemborski, Jacquie, Bruneau, Julie, Clipman, Steven J, Coffin, Carla S, Croxford, Sara, DeBeck, Kora, Emanuel, Eva, Hayashi, Kanna, Hermez, Joumana G, Low-Beer, Daniel, Luhmann, Niklas, Macphail, Gisela, Maher, Lisa, Palmateer, Norah E, Patel, Eshan U, Sacks-Davis, Rachel, Van Den Boom, Wijnand, van Santen, Daniela K, Walker, Josephine G, Hickman, Matthew, Vickerman, Peter, Group, HIV and HCV Incidence Review Collaborative, Aladashvili, Malvina, Azim, Tasnim, Dietze, Paul, Dumchev, Kostyantyn, Havens, Jennifer R, Hellard, Margaret, Hutchinson, Sharon, Iversen, Jennifer, Judd, Ali, Kåberg, Martin, Kurth, Ann E, Mehta, Shruti H, Mravčík, Viktor, Prins, Maria, Solomon, Sunil S, Strathdee, Steffanie A, Sypsa, Vana, Todd, Catherine S, Valencia, Jorge, and Wisse, Ernst

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Hepatitis, Infectious Diseases, Social Determinants of Health, Digestive Diseases, Chronic Liver Disease and Cirrhosis, Hepatitis - C, Sexually Transmitted Infections, Women's Health, Drug Abuse (NIDA only), Emerging Infectious Diseases, Substance Misuse, HIV/AIDS, Liver Disease, Infection, Good Health and Well Being, Male, Humans, Female, Hepacivirus, Substance Abuse, Intravenous, Drug Users, Incidence, HIV Infections, Canada, Hepatitis C, HIV and HCV Incidence Review Collaborative Group, Clinical sciences
Abstract

BackgroundMeasuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to summarise global data on HIV and primary HCV incidence among PWID and associations with age and sex or gender.MethodsIn this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies among PWID by searching MEDLINE, Embase, and PsycINFO, capturing studies published between Jan 1, 2000, and Dec 12, 2022, with no language or study design restrictions. We contacted authors of identified studies for unpublished or updated data. We included studies that estimated incidence by longitudinally re-testing people at risk of infection or by using assays for recent infection. We pooled incidence and relative risk (RR; young [generally defined as ≤25 years] vs older PWID; women vs men) estimates using random-effects meta-analysis and assessed risk of bias with a modified Newcastle-Ottawa scale. This study is registered with PROSPERO, CRD42020220884.FindingsOur updated search identified 9493 publications, of which 211 were eligible for full-text review. An additional 377 full-text records from our existing database and five records identified through cross-referencing were assessed. Including 28 unpublished records, 125 records met the inclusion criteria. We identified 64 estimates of HIV incidence (30 from high-income countries [HICs] and 34 from low-income or middle-income countries [LMICs]) and 66 estimates of HCV incidence (52 from HICs and 14 from LMICs). 41 (64%) of 64 HIV and 42 (64%) of 66 HCV estimates were from single cities rather than being multi-city or nationwide. Estimates were measured over 1987-2021 for HIV and 1992-2021 for HCV. Pooled HIV incidence was 1·7 per 100 person-years (95% CI 1·3-2·3; I2=98·4%) and pooled HCV incidence was 12·1 per 100 person-years (10·0-14·6; I2=97·2%). Young PWID had a greater risk of HIV (RR 1·5, 95% CI 1·2-1·8; I2=66·9%) and HCV (1·5, 1·3-1·8; I2=70·6%) acquisition than older PWID. Women had a greater risk of HIV (RR 1·4, 95% CI 1·1-1·6; I2=55·3%) and HCV (1·2, 1·1-1·3; I2=43·3%) acquisition than men. For both HIV and HCV, the median risk-of-bias score was 6 (IQR 6-7), indicating moderate risk.InterpretationAlthough sparse, available HIV and HCV incidence estimates offer insights into global levels of HIV and HCV transmission among PWID. Intensified efforts are needed to keep track of the HIV and HCV epidemics among PWID and to expand access to age-appropriate and gender-appropriate prevention services that serve young PWID and women who inject drugs.FundingCanadian Institutes of Health Research, Fonds de recherche du Québec-Santé, Canadian Network on Hepatitis C, UK National Institute for Health and Care Research, and WHO.

Published
2023

10. Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis

Author

Aladashvili, Malvina, Azim, Tasnim, Dietze, Paul, Dumchev, Kostyantyn, Havens, Jennifer R., Hellard, Margaret, Hutchinson, Sharon, Iversen, Jennifer, Judd, Ali, Kåberg, Martin, Kurth, Ann E., Mehta, Shruti H., Mravčík, Viktor, Prins, Maria, Solomon, Sunil S., Strathdee, Steffanie A., Sypsa, Vana, Todd, Catherine S., Valencia, Jorge, Wisse, Ernst, Artenie, Adelina, Stone, Jack, Fraser, Hannah, Stewart, Daniel, Arum, Chiedozie, Lim, Aaron G, McNaughton, Anna L, Trickey, Adam, Ward, Zoe, Abramovitz, Daniela, Alary, Michel, Astemborski, Jacquie, Bruneau, Julie, Clipman, Steven J, Coffin, Carla S, Croxford, Sara, DeBeck, Kora, Emanuel, Eva, Hayashi, Kanna, Hermez, Joumana G, Low-Beer, Daniel, Luhmann, Niklas, Macphail, Gisela, Maher, Lisa, Palmateer, Norah E, Patel, Eshan U, Sacks-Davis, Rachel, Van Den Boom, Wijnand, van Santen, Daniela K, Walker, Josephine G, Hickman, Matthew, and Vickerman, Peter

Published
2023
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17. The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality

Author

Karlsen, Tom H, Sheron, Nick, Zelber-Sagi, Shira, Carrieri, Patrizia, Dusheiko, Geoffrey, Bugianesi, Elisabetta, Pryke, Rachel, Hutchinson, Sharon J, Sangro, Bruno, Martin, Natasha K, Cecchini, Michele, Dirac, Mae Ashworth, Belloni, Annalisa, Serra-Burriel, Miquel, Ponsioen, Cyriel Y, Sheena, Brittney, Lerouge, Alienor, Devaux, Marion, Scott, Nick, Hellard, Margaret, Verkade, Henkjan J, Sturm, Ekkehard, Marchesini, Giulio, Yki-Järvinen, Hannele, Byrne, Chris D, Targher, Giovanni, Tur-Sinai, Aviad, Barrett, Damon, Ninburg, Michael, Reic, Tatjana, Taylor, Alison, Rhodes, Tim, Treloar, Carla, Petersen, Claus, Schramm, Christoph, Flisiak, Robert, Simonova, Marieta Y, Pares, Albert, Johnson, Philip, Cucchetti, Alessandro, Graupera, Isabel, Lionis, Christos, Pose, Elisa, Fabrellas, Núria, Ma, Ann T, Mendive, Juan M, Mazzaferro, Vincenzo, Rutter, Harry, Cortez-Pinto, Helena, Kelly, Deirdre, Burton, Robyn, Lazarus, Jeffrey V, Ginès, Pere, Buti, Maria, Newsome, Philip N, Burra, Patrizia, and Manns, Michael P

Published
2022
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18. Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis

Author

Stone, Jack, Fraser, Hannah, Lim, Aaron G, Walker, Josephine G, Ward, Zoe, MacGregor, Louis, Trickey, Adam, Abbott, Sam, Strathdee, Steffanie A, Abramovitz, Daniela, Maher, Lisa, Iversen, Jenny, Bruneau, Julie, Zang, Geng, Garfein, Richard S, Yen, Yung-Fen, Azim, Tasnim, Mehta, Shruti H, Milloy, Michael-John, Hellard, Margaret E, Sacks-Davis, Rachel, Dietze, Paul M, Aitken, Campbell, Aladashvili, Malvina, Tsertsvadze, Tengiz, Mravčík, Viktor, Alary, Michel, Roy, Elise, Smyrnov, Pavlo, Sazonova, Yana, Young, April M, Havens, Jennifer R, Hope, Vivian D, Desai, Monica, Heinsbroek, Ellen, Hutchinson, Sharon J, Palmateer, Norah E, McAuley, Andrew, Platt, Lucy, Martin, Natasha K, Altice, Frederick L, Hickman, Matthew, and Vickerman, Peter

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Drug Abuse (NIDA only), Hepatitis - C, Emerging Infectious Diseases, Digestive Diseases, HIV/AIDS, Infectious Diseases, Hepatitis, Prevention, Substance Misuse, Liver Disease, Behavioral and Social Science, Chronic Liver Disease and Cirrhosis, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Prevention of disease and conditions, and promotion of well-being, Infection, Good Health and Well Being, Adult, Aged, Aged, 80 and over, Americas, Asia, Southeastern, Australasia, Disease Transmission, Infectious, Europe, Female, HIV Infections, Hepatitis C, Humans, Male, Middle Aged, Prevalence, Prisoners, Risk Assessment, Substance Abuse, Intravenous, Young Adult, Clinical Sciences, Public Health and Health Services, Microbiology, Clinical sciences, Medical microbiology, Epidemiology
Abstract

BackgroundPeople who inject drugs (PWID) experience a high prevalence of incarceration and might be at high risk of HIV and hepatitis C virus (HCV) infection during or after incarceration. We aimed to assess whether incarceration history elevates HIV or HCV acquisition risk among PWID.MethodsIn this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO databases for studies in any language published from Jan 1, 2000 until June 13, 2017 assessing HIV or HCV incidence among PWID. We included studies that measured HIV or HCV incidence among community-recruited PWID. We included only studies reporting original results and excluded studies that evaluated incident infections by self-report. We contacted authors of cohort studies that met the inclusion or exclusion criteria, but that did not report on the outcomes of interest, to request data. We extracted and pooled data from the included studies using random-effects meta-analyses to quantify the associations between recent (past 3, 6, or 12 months or since last follow-up) or past incarceration and HIV or HCV acquisition (primary infection or reinfection) risk among PWID. We assessed the risk of bias of included studies using the Newcastle-Ottawa Scale. Between-study heterogeneity was evaluated using the I2 statistic and the P-value for heterogeneity.FindingsWe included published results from 20 studies and unpublished results from 21 studies. These studies originated from Australasia, western and eastern Europe, North and Latin America, and east and southeast Asia. Recent incarceration was associated with an 81% (relative risk [RR] 1·81, 95% CI 1·40-2·34) increase in HIV acquisition risk, with moderate heterogeneity between studies (I2=63·5%; p=0·001), and a 62% (RR 1·62, 95% CI 1·28-2·05) increase in HCV acquisition risk, also with moderate heterogeneity between studies (I2=57·3%; p=0·002). Past incarceration was associated with a 25% increase in HIV (RR 1·25, 95% CI 0·94-1·65) and a 21% increase in HCV (1·21, 1·02-1·43) acquisition risk.InterpretationIncarceration is associated with substantial short-term increases in HIV and HCV acquisition risk among PWID and could be a significant driver of HCV and HIV transmission among PWID. These findings support the need for developing novel interventions to minimise the risk of HCV and HIV acquisition, including addressing structural risks associated with drug laws and excessive incarceration of PWID.FundingEngineering and Physical Sciences Research Council, National Institute for Health Research, National Institutes of Health.

Published
2018

19. Testing and Treatment Interventions in Community Settings Key to Controlling a Recent Human Immunodeficiency Virus Outbreak Among People Who Inject Drugs in Glasgow: A Modeling Study

Author

Allen, Lara I, primary, Fraser, Hannah, additional, Stone, Jack, additional, McAuley, Andrew, additional, Trayner, Kirsten M A, additional, Metcalfe, Rebecca, additional, Peters, S Erica, additional, Hutchinson, Sharon J, additional, Vickerman, Peter, additional, and Hickman, Matthew, additional

Published
2024
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20. Prevalence of opioid dependence in Scotland 2015–2020: A multi‐parameter estimation of prevalence (MPEP) study

Author

Markoulidakis, Andreas, primary, Hickman, Matthew, additional, McAuley, Andrew, additional, Barnsdale, Lee R., additional, Welton, Nicky J., additional, Glancy, Megan, additional, Shivaji, Tara, additional, Collins, Craig, additional, Lang, Jaroslaw, additional, de Wit, Femke, additional, Hunt, Gordon, additional, Wilkinson, Levin, additional, Fraser, Rosalyn, additional, Yeung, Alan, additional, Horsburgh, Kirsten, additional, Priyadarshi, Saket, additional, Hutchinson, Sharon J., additional, and Jones, Hayley E., additional

Published
2024
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24. A global investment framework for the elimination of hepatitis B

Author

Howell, Jessica, Pedrana, Alisa, Schroeder, Sophia E., Scott, Nick, Aufegger, Lisa, Atun, Rifat, Baptista-Leite, Ricardo, Hirnschall, Gottfried, ‘t Hoen, Ellen, Hutchinson, Sharon J., Lazarus, Jeffrey V., Olufunmilayo, Lesi, Peck, Raquel, Sharma, Manik, Sohn, Annette H., Thompson, Alexander, Thursz, Mark, Wilson, David, and Hellard, Margaret

Published
2021
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25. Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland

Author

Whettlock, Alice, McLeod, Allan, Gasiorowski, Andrew, Merrick, Andrew, McAuley, Andy, Went, April, Purdie, Calum, Fischbacher, Colin, Ramsey, Colin, Bailey, David, Henderson, David, McDonald, Eisin, Drennan, Genna, Gowans, Graeme, Reid, Graeme, Murdoch, Heather, Carruthers, Jade, Murray, Josie, Heatlie, Karen, Donaldson, Lorraine, Paton, Martin, Reid, Martin, Llano, Melissa, Murphy-Hall, Michelle, Hall, Ross, Cameron, Ross, Brownlie, Susan, Gaffney, Adam, Milne, Aynsley, Sullivan, Christopher, McArdle, Edward, Glass, Elaine, Young, Johanna, Malcolm, William, McCoubrey, Jodie, McGurnaghan, Stuart J, Weir, Amanda, Bishop, Jen, Kennedy, Sharon, Blackbourn, Luke A K, McAllister, David A, Hutchinson, Sharon, Caparrotta, Thomas M, Mellor, Joseph, Jeyam, Anita, O'Reilly, Joseph E, Wild, Sarah H, Hatam, Sara, Höhn, Andreas, Colombo, Marco, Robertson, Chris, Lone, Nazir, Murray, Janet, Butterly, Elaine, Petrie, John, Kennon, Brian, McCrimmon, Rory, Lindsay, Robert, Pearson, Ewan, Sattar, Naveed, McKnight, John, Philip, Sam, Collier, Andrew, McMenamin, Jim, Smith-Palmer, Alison, Goldberg, David, McKeigue, Paul M, and Colhoun, Helen M

Published
2021
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27. The influence of recipe disaggregation in dietary assessment: results from the national food consumption survey in Saint Kitts and Nevis.

Author

Patricia Crispim, Sandra, Mendes Elias, Vanessa Cardozo, Matthew-Duncan, Latoya, Francis-Grandeson, Isabella, Jean, Fransen, Padula de Quadros, Victoria, Balcerzak, Agnieszka, Ferreira de Sousa, Rita, de Moraes Frauches, Ariel, Bettega Almeida, Claudia Choma, Hutchinson, Sharon D., Charrondière, U. Ruth, and Holmes, Bridget Anna

Published
2024
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29. aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis

Author

Fan, Rong, Papatheodoridis, George, Sun, Jian, Innes, Hamish, Toyoda, Hidenori, Xie, Qing, Mo, Shuyuan, Sypsa, Vana, Guha, Indra Neil, Kumada, Takashi, Niu, Junqi, Dalekos, George, Yasuda, Satoshi, Barnes, Eleanor, Lian, Jianqi, Suri, Vithika, Idilman, Ramazan, Barclay, Stephen T., Dou, Xiaoguang, Berg, Thomas, Hayes, Peter C., Flaherty, John F., Zhou, Yuanping, Zhang, Zhengang, Buti, Maria, Hutchinson, Sharon J., Guo, Yabing, Calleja, Jose Luis, Lin, Lanjia, Zhao, Longfeng, Chen, Yongpeng, Janssen, Harry L.A., Zhu, Chaonan, Shi, Lei, Tang, Xiaoping, Gaggar, Anuj, Wei, Lai, Jia, Jidong, Irving, William L., Johnson, Philip J., Lampertico, Pietro, and Hou, Jinlin

Published
2020
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30. Global hepatitis C elimination: an investment framework

Author

Pedrana, Alisa, Howell, Jessica, Scott, Nick, Schroeder, Sophia, Kuschel, Christian, Lazarus, Jeffrey V, Atun, Rifat, Baptista-Leite, Ricardo, 't Hoen, Ellen, Hutchinson, Sharon J, Aufegger, Lisa, Peck, Raquel, Sohn, Annette H, Swan, Tracy, Thursz, Mark, Lesi, Olufunmilayo, Sharma, Manik, Thwaites, John, Wilson, David P, and Hellard, Margaret

Published
2020
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32. Genome-Wide Association Study for Alcohol-Related Cirrhosis Identifies Risk Loci in MARC1 and HNRNPUL1

Author

Innes, Hamish, Buch, Stephan, Hutchinson, Sharon, Guha, Indra Neil, Morling, Joanne R., Barnes, Eleanor, Irving, Will, Forrest, Ewan, Pedergnana, Vincent, Goldberg, David, Aspinall, Esther, Barclay, Stephan, Hayes, Peter C., Dillon, John, Nischalke, Hans Dieter, Lutz, Philipp, Spengler, Ulrich, Fischer, Janett, Berg, Thomas, Brosch, Mario, Eyer, Florian, Datz, Christian, Mueller, Sebastian, Peccerella, Teresa, Deltenre, Pierre, Marot, Astrid, Soyka, Michael, McQuillin, Andrew, Morgan, Marsha Y., Hampe, Jochen, and Stickel, Felix

Published
2020
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34. Cost-Effectiveness Analysis of Baseline Testing for Resistance-Associated Polymorphisms to Optimize Treatment Outcome in Genotype 1 Noncirrhotic Treatment-Naïve Patients With Chronic Hepatitis C Virus

Author

Barnes, Eleanor, Ball, Jonathan, Brainard, Diana, Burgess, Gary, Cooke, Graham S., Dillon, John, Foster, Graham, Gore, Charles, Guha, Neil, Halford, Rachel, Whitby, Kevin, Holmes, Chris, Howe, Anita, Hudson, Emma, Hutchinson, Sharon, Irving, William, Khakoo, Salim, Klenerman, Paul, Martin, Natasha, Massetto, Benedetta, Mbisa, Tamyo, McHutchison, John, McKeating, Jane, McLauchlan, John, Miners, Alec, Murray, Andrea, Shaw, Peter, Simmonds, Peter, Spencer, Chris, Thomson, Emma, Vickerman, Peter, Zitzmann, Nicole, Fawsitt, Christopher G., and Welton, Nicky J.

Published
2020
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36. Is increased hepatitis C virus case‐finding combined with current or 8‐week to 12‐week direct‐acting antiviral therapy cost‐effective in UK prisons? A prevention benefit analysis

Author

Martin, Natasha K, Vickerman, Peter, Brew, Iain F, Williamson, Joan, Miners, Alec, Irving, William L, Saksena, Sushma, Hutchinson, Sharon J, Mandal, Sema, O'Moore, Eamonn, and Hickman, Matthew

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Services, Infectious Diseases, HIV/AIDS, Liver Disease, Hepatitis - C, Hepatitis, Cost Effectiveness Research, Clinical Research, Chronic Liver Disease and Cirrhosis, Comparative Effectiveness Research, Substance Misuse, Emerging Infectious Diseases, Digestive Diseases, Infection, Good Health and Well Being, Adolescent, Adult, Aged, Antiviral Agents, Cost-Benefit Analysis, Hepatitis C, Humans, Mass Screening, Middle Aged, Models, Theoretical, Prisoners, Sustained Virologic Response, United Kingdom, Young Adult, Medical Biochemistry and Metabolomics, Immunology, Gastroenterology & Hepatology, Clinical sciences
Abstract

UnlabelledPrisoners have a high prevalence of hepatitis C virus (HCV), but case-finding may not have been cost-effective because treatment often exceeded average prison stay combined with a lack of continuity of care. We assessed the cost-effectiveness of increased HCV case-finding and treatment in UK prisons using short-course therapies. A dynamic HCV transmission model assesses the cost-effectiveness of doubling HCV case-finding (achieved through introducing opt-out HCV testing in UK pilot prisons) and increasing treatment in UK prisons compared to status quo voluntary risk-based testing (6% prison entrants/year), using currently recommended therapies (8-24 weeks) or interferon (IFN)-free direct-acting antivirals (DAAs; 8-12 weeks, 95% sustained virological response, £3300/week). Costs (British pounds, £) and health utilities (quality-adjusted life years) were used to calculate mean incremental cost-effectiveness ratios (ICERs). We assumed 56% referral and 2.5%/25% of referred people who inject drugs (PWID)/ex-PWID treated within 2 months of diagnosis in prison. PWID and ex-PWID or non-PWID are in prison an average 4 and 8 months, respectively. Doubling prison testing rates with existing treatments produces a mean ICER of £19,850/quality-adjusted life years gained compared to current testing/treatment and is 45% likely to be cost-effective under a £20,000 willingness-to-pay threshold. Switching to 8-week to 12-week IFN-free DAAs in prisons could increase cost-effectiveness (ICER £15,090/quality-adjusted life years gained). Excluding prevention benefit decreases cost-effectiveness. If >10% referred PWID are treated in prison (2.5% base case), either treatment could be highly cost-effective (ICER

Published
2016

37. Parents' Experiences during Their Infant's Transition from Neonatal Intensive Care Unit to Home: A Qualitative Study

Author

Hutchinson, Sharon W., Spillet, Marydee A., and Cronin, Mary

Abstract

Limited literature exists which examines how parents of infants hospitalized in the Neonatal Intensive Care Unit (NICU) transition from their infant's NICU hospital stay to home. This study examines the question, "What are the experiences of parents during their infant's transition from the NICU to home?" Grounded theory methods served as the paradigm to explore twelve NICU parents' experiences during their infant's transition. The basic social psychological process identified was "becoming a parent" which was based on the core problem "I'm not a parent." Analysis of data contributed to a model described by the researchers as the resultant Model of Parental Progression that describes how the parents proceeded through their experiences of their infants' transitions from the NICU to home. (Contains 1 figure and 2 tables.)

Published
2012

38. Hepatitis C virus treatment as prevention in people who inject drugs

Author

Hickman, Matthew, De Angelis, Daniela, Vickerman, Peter, Hutchinson, Sharon, and Martin, Natasha Kaleta

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Hepatitis - C, Hepatitis, HIV/AIDS, Liver Disease, Emerging Infectious Diseases, Drug Abuse (NIDA only), Clinical Research, Chronic Liver Disease and Cirrhosis, Substance Misuse, Infectious Diseases, Prevention, Infection, Good Health and Well Being, Antiviral Agents, Cost-Benefit Analysis, Evidence-Based Medicine, Hepacivirus, Hepatitis C, Humans, Interferons, Models, Theoretical, Practice Guidelines as Topic, Substance Abuse, Intravenous, Treatment Outcome, United Kingdom, Viral Load, evaluation, hepatitis C virus, injecting drug use, prevention, treatment, Microbiology, Medical Microbiology, Clinical sciences
Abstract

Purpose of reviewThe majority of hepatitis C virus (HCV) infections in the United Kingdom and many developing countries were acquired through injecting. New clinical guidance suggests that HCV treatment should be offered to people with a transmission risk - such as people who inject drugs (PWID) - irrespective of severity of liver disease. We consider the strength of the evidence base and potential problems in evaluating HCV treatment as prevention among PWID.Recent findingsThere is good theoretical evidence from dynamic models that HCV treatment for PWID could reduce HCV chronic prevalence and incidence among PWID. Economic evaluations from high-income settings have suggested HCV treatment for PWID is cost-effective, and that in many settings HCV treatment of PWID could be more cost-effective than treating those at an equivalent stage with no ongoing transmission risk. Epidemiological studies of older interferon treatments have suggested that PWID can achieve similar treatment outcomes to other patient groups treated for chronic HCV. Impact and cost-effectiveness of HCV treatment is driven by the potential 'prevention benefit' of treating PWID. Model projections suggest that more future infections, end stage liver disease, and HCV-related deaths will be averted than lost through reinfection of PWID treated successfully for HCV. However, there is to date no empirical evidence from trials or observational studies that test the model projections and 'prevention benefit' hypothesis. In part this is because of uncertainty in the evidence base but also there is unlikely to have been a change in HCV prevalence due to HCV treatment because PWID HCV treatment rates historically in most sites have been low, and any scale-up and switch to the new direct acting antiviral has not yet occurred. There are a number of key uncertainties in the data available on PWID that need to be improved and addressed to evaluate treatment as prevention. These include estimates of the prevalence of PWID, measurements of HCV chronic prevalence and incidence among PWID, and how to interpret reinfection rates as potential outcome measures.SummaryEliminating HCV through scaling up treatment is a theoretical possibility. But empirical data are required to demonstrate that HCV treatment can reduce HCV transmission, which will require an improved evidence base and analytic framework for measuring PWID and HCV prevalence.

Published
2015

39. Cost-Effectiveness of HBV and HCV Screening Strategies – A Systematic Review of Existing Modelling Techniques

Author

Geue, Claudia, Wu, Olivia, Xin, Yiqiao, Heggie, Robert, Hutchinson, Sharon, Martin, Natasha K, Fenwick, Elisabeth, and Goldberg, David

Subjects
Economics, Biomedical and Clinical Sciences, Applied Economics, Hepatitis - C, Prevention, Emerging Infectious Diseases, Clinical Research, Health Services, Digestive Diseases, Liver Disease, Cost Effectiveness Research, Infectious Diseases, Chronic Liver Disease and Cirrhosis, Comparative Effectiveness Research, HIV/AIDS, Hepatitis, Hepatitis - B, 4.2 Evaluation of markers and technologies, 8.2 Health and welfare economics, Aetiology, Detection, screening and diagnosis, 2.5 Research design and methodologies (aetiology), Health and social care services research, Infection, Good Health and Well Being, Costs and Cost Analysis, Hepacivirus, Hepatitis B, Hepatitis B virus, Hepatitis C, Humans, Mass Screening, Models, Economic, Consortium, ECDC, General Science & Technology
Abstract

IntroductionStudies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches.MethodsA structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions.ResultsThe overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology.ConclusionWhen assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers.

Published
2015

42. A Cost-Effectiveness Analysis of Shortened Direct-Acting Antiviral Treatment in Genotype 1 Noncirrhotic Treatment-Naive Patients With Chronic Hepatitis C Virus

Author

Barnes, Eleanor, Ball, Jonathan, Brainard, Diana, Burgess, Gary, Cooke, Graham, Dillon, John, Foster, Graham, Gore, Charles, Guha, Neil, Halford, Rachel, Whitby, Kevin, Holmes, Chris, Howe, Anita, Hudson, Emma, Hutchinson, Sharon, Irving, William, Khakoo, Salim, Klenerman, Paul, Martin, Natasha, Massetto, Benedetta, Mbisa, Tamyo, McHutchison, John, McKeating, Jane, McLauchlan, John, Miners, Alec, Murray, Andrea, Shaw, Peter, Simmonds, Peter, Spencer, Chris, Thomson, Emma, Vickerman, Peter, Zitzmann, Nicole, Fawsitt, Christopher G., and Welton, Nicky J.

Published
2019
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45. Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

Author

Abdo, Ayman, Aggarwal, Rakesh, Aghemo, Alessio, Al-Judaibi, Bandar, Al Mahtab, Mamun, Altaf, Arshad, Ameen, Zyaad, Asselah, Tarik, Baatarkkhuu, Oidov, Barber, Ella, Barnes, Eleanor, Boulet, Pascale, Burrows, Louise, Butsashvili, Maia, Chan, Erica, Chow, Chelsea, Cowie, Ben, Cunningham, Chris, de Araujo, Alexandre, Diap, Graciela, Dore, Greg, Doyle, Joseph, Elsayed, Manal, Fajardo, Emmanuel, Gane, Ed, Getahun, Aneley, Goldberg, David, Got, Tiffany, Hickman, Matthew, Hill, Andrew, Hutchinson, Sharon, Jones, Chris, Kamili, Saleem, Khan, Amreen, Lee, Alice, Lee, Tin Yan, Malani, Jioiji, Morris, Tammy Meyers, Nayagam, Shevanthi, Njouom, Richard, Ocama, Ponsiano, Pedrana, Alisa, Peeling, Rosanna, Reddy, Amulya, Sacks, Jilian, Sarin, Shiv, Shimakawa, Yusuke, Silva, Marcela, Skala, Pavlo, Taylor-Robinson, Simon, Thompson, Alex, Thursz, Mark, Tonganibeia, Alfred, Wallace, Jack, Ward, James, Wolff, Fernando, Vickerman, Peter, Yau, Johnny, Cooke, Graham S, Andrieux-Meyer, Isabelle, Applegate, Tanya L, Atun, Rifat, Burry, Jessica R, Cheinquer, Hugo, Dusheiko, Geoff, Feld, Jordan J, Gore, Charles, Griswold, Max G, Hamid, Saeed, Hellard, Margaret E, Hou, JinLin, Howell, Jess, Jia, Jidong, Kravchenko, Natalia, Lazarus, Jeffrey V, Lemoine, Maud, Lesi, Olufunmilayo A, Maistat, Liudmyla, McMahon, Brian J, Razavi, Homie, Roberts, Teri, Simmons, Bryony, Sonderup, Mark W, Spearman, C Wendy, Taylor, Bridie E, Thomas, David L, Waked, Imam, Ward, John W, and Wiktor, Stefan Z

Published
2019
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46. SARS-CoV-2 vaccine uptake and risks of severe COVID-19 disease among people prescribed opioid agonist therapy in Scotland.

Author

Yeung, Alan, Wilkinson, Max, Bishop, Jen, Taylor, Bob, Palmateer, Norah, Barnsdale, Lee, Lang, Jaroslaw, Cameron, Claire, McCormick, Duncan, Clusker, Tracey, McAuley, Andrew, and Hutchinson, Sharon

Subjects
RISK assessment, RESEARCH funding, LOGISTIC regression analysis, DRUG addiction, COVID-19 vaccines, SEVERITY of illness index, DESCRIPTIVE statistics, ODDS ratio, OPIOID analgesics, CASE-control method, CONFIDENCE intervals, DRUG abusers, COVID-19, VACCINATION status
Published
2024
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