ArticleThe Lancet. Infectious diseases2018
Hepatitis C virus treatment as prevention in an extended network of people who inject drugs in the USA: a modelling study.
Article in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Co-circulating pathogens of humans: a systematic review of mechanistic transmission models.Proceedings. Biological sciences · 2025Pooled it
- A Review of Network Models for HIV Spread.Journal of acquired immune deficiency syndromes (1999) · 2025Pooled it
- The development of a pan-genotypic T cell vaccine against hepatitis C virus using heterologous prime-boost strategies.Hepatology (Baltimore, Md.) · 2026Article
- Geometric deep learning enables high-fidelity network imputation for HIV transmission modeling.Communications medicine · 2026Article
- Hepatitis C virus transmission among people who inject drugs in rural United States: mathematical modeling study using stochastic agent-based network simulation.American journal of epidemiology · 2026Article
- Rationale, design, and methodology of a randomized controlled trial evaluating the impact of peer-enhanced care coordination on linkage to HCV care among formerly incarcerated individuals.Contemporary clinical trials · 2025Article
- Modeling of randomized hepatitis C vaccine trials: Bridging the gap between controlled human infection models and real-word testing.PNAS nexus · 2025Article
- Control and Elimination of Hepatitis C Virus Among People With HIV in Australia: Extended Follow-up of the CEASE Cohort (2014-2023).Open forum infectious diseases · 2024Article
- Sexually Transmitted Infection (STI) Incidence, STI Screening, and Human Immunodeficiency Virus Preexposure Prophylaxis Uptake in United States Veterans With Opioid Use Disorder in Long Island, New York.Open forum infectious diseases · 2024Article
- Potential impact of curative and preventive interventions toward hepatitis C elimination in people who inject drugs-A network modeling study.The International journal on drug policy · 2024Article
- Decrease in active hepatitis C infection among people who use drugs in Madrid, Spain, 2017 to 2023: a retrospective study.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- HCV prevalence and phylogenetic characteristics in a cross-sectional, community study of young people who inject drugs in New York City: Opportunity for and threats to HCV elimination.Health science reports · 2024Article
- Medicaid Expansion and Restriction Policies for Hepatitis C Treatment.JAMA network open · 2024Article
- Hepatitis C virus micro-elimination in people who inject drugs: Challenges and chance in Taiwan and worldwide.The Kaohsiung journal of medical sciences · 2024Review
- Influence of polysubstance use on the health-related quality of life among people who inject drugs undergoing opioid agonist treatment following treatment for hepatitis c virus.Journal of substance use · 2024Article
- Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya.The International journal on drug policy · 2023Article
- Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection.Annals of medicine · 2022Article
- Extent and implications of omitted ties on network measures in a longitudinal social network survey of people who use drugs.Drug and alcohol dependence · 2022Article
- Observational
- The role of low-income and middle-income country prisons in eliminating hepatitis C.The Lancet. Public health · 2022Article
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Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundChronic infections with hepatitis C virus (HCV) and HIV are highly prevalent in the USA and concentrated in people who inject drugs. Treatment as prevention with highly effective new direct-acting antivirals is a prospective HCV elimination strategy. We used network-based modelling to analyse the effect of this strategy in HCV-infected people who inject drugs in a US city.
methodsFive graph models were fit using data from 1574 people who inject drugs in Hartford, CT, USA. We used a degree-corrected stochastic block model, based on goodness-of-fit, to model networks of injection drug users. We simulated transmission of HCV and HIV through this network with varying levels of HCV treatment coverage (0%, 3%, 6%, 12%, or 24%) and varying baseline HCV prevalence in people who inject drugs (30%, 60%, 75%, or 85%). We compared the effectiveness of seven treatment-as-prevention strategies on reducing HCV prevalence over 10 years and 20 years versus no treatment. The strategies consisted of treatment assigned to either a randomly chosen individual who injects drugs or to an individual with the highest number of injection partners. Additional strategies explored the effects of treating either none, half, or all of the injection partners of the selected individual, as well as a strategy based on respondent-driven recruitment into treatment.
findingsOur model estimates show that at the highest baseline HCV prevalence in people who inject drugs (85%), expansion of treatment coverage does not substantially reduce HCV prevalence for any treatment-as-prevention strategy. However, when baseline HCV prevalence is 60% or lower, treating more than 120 (12%) individuals per 1000 people who inject drugs per year would probably eliminate HCV within 10 years. On average, assigning treatment randomly to individuals who inject drugs is better than targeting individuals with the most injection partners. Treatment-as-prevention strategies that treat additional network members are among the best performing strategies and can enhance less effective strategies that target the degree (ie, the highest number of injection partners) within the network.
interpretationSuccessful HCV treatment as prevention should incorporate the baseline HCV prevalence and will achieve the greatest benefit when coverage is sufficiently expanded.
fundingNational Institute on Drug Abuse.
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