Skip to content

Modelling the impact of a national scale-up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland

Research output: Contribution to journalArticle

Standard

Modelling the impact of a national scale-up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland. / Fraser, Hannah; Mukandavire, Christinah; Martin, Natasha; Goldberg, David; Palmateer, Norah; Munro, Alison; Taylor, Avril; Hickman, Matthew; Hutchinson, Sharon; Vickerman, Peter.

In: Addiction, Vol. 113, No. 11, 11.2018, p. 2118-2131.

Research output: Contribution to journalArticle

Harvard

APA

Vancouver

Author

Fraser, Hannah ; Mukandavire, Christinah ; Martin, Natasha ; Goldberg, David ; Palmateer, Norah ; Munro, Alison ; Taylor, Avril ; Hickman, Matthew ; Hutchinson, Sharon ; Vickerman, Peter. / Modelling the impact of a national scale-up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland. In: Addiction. 2018 ; Vol. 113, No. 11. pp. 2118-2131.

Bibtex

@article{97c311fdc05c459eb86da21151084d11,
title = "Modelling the impact of a national scale-up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland",
abstract = "Background and Aims: To reduce hepatitis C virus (HCV) transmission among people who inject drugs (PWID), Scottish Government-funded national strategies, launched in 2008, promoted scaling-up opioid substitution therapy (OST) and needle and syringe provision (NSP), with some increases in HCV treatment. We test whether observed decreases in HCV incidence post-2008 can be attributed to this intervention scale-up.Design: A dynamic HCV transmission model amongst PWID incorporating intervention scale-up and observed decreases in behavioural risk, calibrated to Scottish HCV prevalence and incidence data for 2008/09. Setting: Scotland, UKParticipants: PWID Measurements: Model projections from 2008-2015 were compared with data to test whether they were consistent with observed decreases in HCV incidence amongst PWID while incorporating the observed intervention scale-up, and to determine the impact of scaling-up interventions on incidence. Findings: Without fitting to epidemiological data post-2008/09, the model incorporating observed intervention scale-up agreed with observed decreases in HCV incidence amongst PWID between 2008-2015, suggesting HCV incidence decreased by 61.3{\%} (95{\%} credibility interval 45.1-75.3{\%}) from 14.2/100pyrs (9.0-20.7) to 5.5/100pyrs (2.9-9.2). On average, each model fit lay within 84{\%} (10.1/12) of the confidence bounds for the 12 incidence data points which the model was compared against. We estimate that scale-up of interventions (OST+NSP+HCV treatment) and decreases in high-risk behaviour from 2008-2015 resulted in a 33.9{\%} (23.8-44.6{\%}) decrease in incidence, with the remainder (27.4{\%} (17.6-37.0{\%})) explained by historical changes in OST+NSP coverage and risk pre-2008. Projections suggest scaling-up of all interventions post-2008 averted 1,492 (657-2,646) infections over 7-years, with 1,016 (308-1,996), 404 (150-836) and 72 (27-137) due to scale-up of OST+NSP, decreases in high-risk behaviour, and HCV treatment, respectively. Conclusions: Most of the decline in hepatitis C virus (HCV) incidence in Scotland between 2008-2015 appears to be attributable to intervention scale-up (opioid substitution therapy and needle and syringe provision) due to government strategies on HCV and drugs.",
keywords = "Hepatitis C, people who inject drugs, injecting drug users, opioid substitution therapy, needle and syringe programmes, Scotland",
author = "Hannah Fraser and Christinah Mukandavire and Natasha Martin and David Goldberg and Norah Palmateer and Alison Munro and Avril Taylor and Matthew Hickman and Sharon Hutchinson and Peter Vickerman",
year = "2018",
month = "11",
doi = "10.1111/add.14267",
language = "English",
volume = "113",
pages = "2118--2131",
journal = "Addiction",
issn = "0965-2140",
publisher = "Wiley",
number = "11",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Modelling the impact of a national scale-up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland

AU - Fraser, Hannah

AU - Mukandavire, Christinah

AU - Martin, Natasha

AU - Goldberg, David

AU - Palmateer, Norah

AU - Munro, Alison

AU - Taylor, Avril

AU - Hickman, Matthew

AU - Hutchinson, Sharon

AU - Vickerman, Peter

PY - 2018/11

Y1 - 2018/11

N2 - Background and Aims: To reduce hepatitis C virus (HCV) transmission among people who inject drugs (PWID), Scottish Government-funded national strategies, launched in 2008, promoted scaling-up opioid substitution therapy (OST) and needle and syringe provision (NSP), with some increases in HCV treatment. We test whether observed decreases in HCV incidence post-2008 can be attributed to this intervention scale-up.Design: A dynamic HCV transmission model amongst PWID incorporating intervention scale-up and observed decreases in behavioural risk, calibrated to Scottish HCV prevalence and incidence data for 2008/09. Setting: Scotland, UKParticipants: PWID Measurements: Model projections from 2008-2015 were compared with data to test whether they were consistent with observed decreases in HCV incidence amongst PWID while incorporating the observed intervention scale-up, and to determine the impact of scaling-up interventions on incidence. Findings: Without fitting to epidemiological data post-2008/09, the model incorporating observed intervention scale-up agreed with observed decreases in HCV incidence amongst PWID between 2008-2015, suggesting HCV incidence decreased by 61.3% (95% credibility interval 45.1-75.3%) from 14.2/100pyrs (9.0-20.7) to 5.5/100pyrs (2.9-9.2). On average, each model fit lay within 84% (10.1/12) of the confidence bounds for the 12 incidence data points which the model was compared against. We estimate that scale-up of interventions (OST+NSP+HCV treatment) and decreases in high-risk behaviour from 2008-2015 resulted in a 33.9% (23.8-44.6%) decrease in incidence, with the remainder (27.4% (17.6-37.0%)) explained by historical changes in OST+NSP coverage and risk pre-2008. Projections suggest scaling-up of all interventions post-2008 averted 1,492 (657-2,646) infections over 7-years, with 1,016 (308-1,996), 404 (150-836) and 72 (27-137) due to scale-up of OST+NSP, decreases in high-risk behaviour, and HCV treatment, respectively. Conclusions: Most of the decline in hepatitis C virus (HCV) incidence in Scotland between 2008-2015 appears to be attributable to intervention scale-up (opioid substitution therapy and needle and syringe provision) due to government strategies on HCV and drugs.

AB - Background and Aims: To reduce hepatitis C virus (HCV) transmission among people who inject drugs (PWID), Scottish Government-funded national strategies, launched in 2008, promoted scaling-up opioid substitution therapy (OST) and needle and syringe provision (NSP), with some increases in HCV treatment. We test whether observed decreases in HCV incidence post-2008 can be attributed to this intervention scale-up.Design: A dynamic HCV transmission model amongst PWID incorporating intervention scale-up and observed decreases in behavioural risk, calibrated to Scottish HCV prevalence and incidence data for 2008/09. Setting: Scotland, UKParticipants: PWID Measurements: Model projections from 2008-2015 were compared with data to test whether they were consistent with observed decreases in HCV incidence amongst PWID while incorporating the observed intervention scale-up, and to determine the impact of scaling-up interventions on incidence. Findings: Without fitting to epidemiological data post-2008/09, the model incorporating observed intervention scale-up agreed with observed decreases in HCV incidence amongst PWID between 2008-2015, suggesting HCV incidence decreased by 61.3% (95% credibility interval 45.1-75.3%) from 14.2/100pyrs (9.0-20.7) to 5.5/100pyrs (2.9-9.2). On average, each model fit lay within 84% (10.1/12) of the confidence bounds for the 12 incidence data points which the model was compared against. We estimate that scale-up of interventions (OST+NSP+HCV treatment) and decreases in high-risk behaviour from 2008-2015 resulted in a 33.9% (23.8-44.6%) decrease in incidence, with the remainder (27.4% (17.6-37.0%)) explained by historical changes in OST+NSP coverage and risk pre-2008. Projections suggest scaling-up of all interventions post-2008 averted 1,492 (657-2,646) infections over 7-years, with 1,016 (308-1,996), 404 (150-836) and 72 (27-137) due to scale-up of OST+NSP, decreases in high-risk behaviour, and HCV treatment, respectively. Conclusions: Most of the decline in hepatitis C virus (HCV) incidence in Scotland between 2008-2015 appears to be attributable to intervention scale-up (opioid substitution therapy and needle and syringe provision) due to government strategies on HCV and drugs.

KW - Hepatitis C

KW - people who inject drugs

KW - injecting drug users

KW - opioid substitution therapy

KW - needle and syringe programmes

KW - Scotland

U2 - 10.1111/add.14267

DO - 10.1111/add.14267

M3 - Article

VL - 113

SP - 2118

EP - 2131

JO - Addiction

JF - Addiction

SN - 0965-2140

IS - 11

ER -