Impact and cost-effectiveness of scaling up HCV testing and treatment strategies for achieving HCV elimination among people who inject drugs in England: a mathematical modelling study
2024

Scaling Up HCV Testing and Treatment for Elimination in England

publication 10 minutes Evidence: high

Author Information

Author(s): Ward Zoe, Simmons Ruth, Fraser Hannah, Trickey Adam, Kesten Jo, Gibson Andy, Reid Leila, Cox Sean, Gordon Fiona, Mc Pherson Stuart, Ryder Stephen, Vilar Javier, Miners Alec, Williams Jack, Emmanouil Beatrice, Desai Monica, Coughlan Laura, Harris Ross, Foster Graham R., Hickman Matthew, Mandal Sema, Vickerman Peter

Primary Institution: Bristol Medical School, University of Bristol, Bristol, UK

Hypothesis

What testing and treatment strategies will achieve the WHO target for HCV elimination among people who inject drugs in England?

Conclusion

Many regions in England could reach the WHO HCV elimination target by 2030 with existing testing and treatment pathways, and scaling up testing in drug treatment centers or prisons is highly cost-effective.

Supporting Evidence

  • Existing testing and treatment pathways have decreased HCV incidence among PWID by 56.1–85.4% over 2016–2023.
  • Scaling up testing in drug treatment centers to 80% is projected to significantly increase the probability of reaching the HCV elimination target.
  • The study provides one of the first analyses of ongoing country-level HCV elimination initiatives among PWID.

Takeaway

This study shows that if more people who inject drugs get tested for hepatitis C, we can help stop the disease from spreading and save lives.

Methodology

A dynamic deterministic HCV transmission model was developed for four regions in England, assessing existing and improved testing and treatment pathways.

Potential Biases

Potential under-reporting of HCV treatments and misclassification of injecting drug use status may introduce bias.

Limitations

Some model parameters remain uncertain, and the study only evaluated 4 out of 22 operational delivery networks in England.

Participant Demographics

The study focused on people who inject drugs (PWID) in four regions of England.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CrI

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1016/j.lanepe.2024.101176

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