ArticleBMC infectious diseases2017
The need for treatment scale-up to impact HCV transmission in people who inject drugs in Montréal, Canada: a modelling study.
Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Pooled it
- Hepatitis C Reinfection in People Who Inject Drugs in Resource-Limited Countries: A Systematic Review and Analysis.International journal of environmental research and public health · 2020Pooled it
- Impact of Risk Heterogeneity on the Feasibility of Hepatitis C Elimination Among People Who Inject Drugs: A Modelling Study.Journal of viral hepatitis · 2025Article
- Achieving Hepatitis C Micro-Elimination in Chinese Injecting Drug Users: A Dynamic Network Modeling Study.Infectious diseases and therapy · 2025Article
- Article
- Expanding access to healthcare for people who use drugs and sex workers: hepatitis C elimination implications from a qualitative study of healthcare experiences in British Columbia, Canada.Harm reduction journal · 2024Article
- Article
- Public health interventions, priority populations, and the impact of COVID-19 disruptions on hepatitis C elimination among people who have injected drugs in Montreal (Canada): A modeling study.The International journal on drug policy · 2023Article
- Adherence to opioid agonist therapy predicts uptake of direct-acting antivirals in people who use drugs: results from the French national healthcare database (the ANRS FANTASIO study).Harm reduction journal · 2022Article
- Modeling hepatitis C micro-elimination among people who inject drugs with direct-acting antivirals in metropolitan Chicago.PloS one · 2022Article
- The hepatitis C epidemic in Canada: An overview of recent trends in surveillance, injection drug use, harm reduction and treatment.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2021Article
- "I want to get better, but…": identifying the perceptions and experiences of people who inject drugs with respect to evolving hepatitis C virus treatments.International journal for equity in health · 2021Article
- A review of network simulation models of hepatitis C virus and HIV among people who inject drugs.The International journal on drug policy · 2021Review
- Hepatitis C (HCV) therapy for HCV mono-infected and HIV-HCV co-infected individuals living in Nepal.PLoS neglected tropical diseases · 2020Article
- Mathematical modeling of hepatitis c virus (HCV) prevention among people who inject drugs: A review of the literature and insights for elimination strategies.Journal of theoretical biology · 2019Review
- Hepatitis C transmission in young people who inject drugs: Insights using a dynamic model informed by state public health surveillance.Epidemics · 2019Article
- HIV Serostatus and Having Access to a Physician for Regular Hepatitis C Virus Care Among People Who Inject Drugs.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Non-invasive liver fibrosis assessment and HCV treatment initiation within a systematic screening program in HIV/HCV coinfected patients.Wiener klinische Wochenschrift · 2018Article
- The role of prevention strategies in achieving HCV elimination in Canada: what are the remaining challenges?Canadian liver journal · 2018Review
- Disparities in direct acting antivirals uptake in HIV-hepatitis C co-infected populations in Canada.Journal of the International AIDS Society · 2017Article
Corrections and comments
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Authors and funding
8 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundHCV transmission remains high in people who inject drugs (PWID) in Montréal. New direct-acting antivirals (DAAs), highly effective and more tolerable than previous regimens, make a "Treatment as Prevention" (TasP) strategy more feasible. This study assesses how improvements in the cascade of care could impact hepatitis C burden among PWID in Montréal.
methodsWe used a dynamic model to simulate HCV incidence and prevalence after 10 years, and cirrhosis complications after 10 and 40 years. Eight scenarios of improved cascade of care were examined.
resultsUsing a baseline incidence and prevalence of 22.1/100 person-years (PY) and 53.1%, implementing the current cascade of care using DAAs would lead to HCV incidence and prevalence estimates at 10 years of 9.4/100PY and 55.8%, respectively. Increasing the treatment initiation rate from 5%/year initially to 20%/year resulted in large decreases in incidence (6.4/100PY), prevalence (36.6%), and cirrhosis complications (-18%/-37% after 10/40 years). When restricting treatment to fibrosis level ≥ F2 instead of F0 (reference scenario), such decreases in HCV occurrence were unreachable. Improving the whole cascade of care led to the greatest effect by halving both the incidence and prevalence at 10 years, and the number of cirrhosis complications after 40 years.
conclusionsThe current level of treatment access in Montréal is limiting a massive decrease in hepatitis C burden among PWID. A substantial treatment scale-up, regardless of fibrosis level, is necessary. While improving the rest of the cascade of care is necessary to optimize a TasP strategy and control the HCV epidemic, a treatment scale-up is first needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.