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Insights into Hepatitis C Transmission in Young Persons who Inject Drugs: Results From a Dynamic Modeling Approach Informed by State-Level Public Health Surveillance Data

View ORCID ProfileRachel E Gicquelais, View ORCID ProfileBetsy Foxman, View ORCID ProfileJoseph Coyle, View ORCID ProfileMarisa C Eisenberg
doi: https://doi.org/10.1101/193185
Rachel E Gicquelais
1Department of Epidemiology, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, Michigan
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Betsy Foxman
1Department of Epidemiology, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, Michigan
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Joseph Coyle
2Michigan Department of Health and Human Services
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Marisa C Eisenberg
1Department of Epidemiology, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, Michigan
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Abstract

Rising use of heroin and prescription opioids are major contributors to increases in Hepatitis C Virus (HCV) incidence in US young adults since the late 1990s. How best to interrupt transmission and decrease HCV prevalence in young persons who inject drugs (PWID) is uncertain, but modeling studies in older populations support interventions that increase HCV treatment among all PWID. We developed a transmission model of young (aged 15-30 years) PWID, which we fit to state-level US HCV surveillance data, and simulated the potential impact of primary (reducing injection initiation), secondary (increasing cessation, reducing injection partners, or reducing injection drug use relapse), and tertiary (HCV treatment) interventions on incident and prevalent HCV cases. Interventions with primary prevention initiatives (reducing injection initiation) yielded concurrent reductions to HCV incidence and prevalence. Treatment of former PWID led to prevalence reductions but did not reduce incidence. Treatment of current and former PWID without other interventions led to incidence reductions in scenarios with high injection initiation rates, high syringe sharing, and low relapse rates after injection cessation. While these results are specific to Michigan, our approach could be applied in other states conducting HCV surveillance to identify local-level intervention opportunities.

Footnotes

  • Abbreviations
    DAA
    Directly acting antiviral
    HCV
    Hepatitis C Virus
    IDU
    Injection Drug Use
    PWID
    People who Inject Drugs or Person who Injects Drugs
    US
    United States

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted September 24, 2017.
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Insights into Hepatitis C Transmission in Young Persons who Inject Drugs: Results From a Dynamic Modeling Approach Informed by State-Level Public Health Surveillance Data
Rachel E Gicquelais, Betsy Foxman, Joseph Coyle, Marisa C Eisenberg
bioRxiv 193185; doi: https://doi.org/10.1101/193185
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Insights into Hepatitis C Transmission in Young Persons who Inject Drugs: Results From a Dynamic Modeling Approach Informed by State-Level Public Health Surveillance Data
Rachel E Gicquelais, Betsy Foxman, Joseph Coyle, Marisa C Eisenberg
bioRxiv 193185; doi: https://doi.org/10.1101/193185

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