Agent-Based Model Forecasts Aging of the Population of People Who Inject Drugs in Metropolitan Chicago and Changing Prevalence of Hepatitis C Infections.
Agent-Based Model Forecasts Aging of the Population of People Who Inject Drugs in Metropolitan Chicago and Changing Prevalence of Hepatitis C Infections.
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DOI：
10.1371/journal.pone.0137993
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Major ME
中科院分区：
文献类型：
--
作者：
Gutfraind A;Boodram B;Prachand N;Hailegiorgis A;Dahari H;Major ME
注射吸毒者（PWID）在共用受污染的注射设备期间传播血源性病原体的风险很高，特别是丙型肝炎病毒（HCV）。 HCV 患病率受到吸毒行为、社交网络、地理位置以及针具交换计划等干预措施的可用性的复杂相互作用的影响。为了充分解决 HCV 流行预测中的这种复杂性，我们开发了一种计算模型，即基于代理的病原体动力学模型 (APK)。 APK 模拟芝加哥大都市的吸毒者人群，包括导致 HCV 感染的社交互动。我们使用芝加哥注射吸毒者的多个经验数据源来构建计算机注射吸毒者人口的空间分布，并考虑城市及其郊区的地理，对注射吸毒者之间的网络进行建模。 APK 根据 2012 年经验数据（最新可用）进行验证，并显示与网络和流行病学调查的一致性在 1% 以内。在2010年至2020年期间，APK预测HCV患病率每年下降0.8%，从44(±2)%降至36(±5)%，尽管一些亚人群的患病率将继续相对较高，包括非西班牙裔黑人，为48(±5)%。非西班牙裔白人的下降率最低，我们发现，与历史趋势相反，非西班牙裔白人的发病率将超过非西班牙裔黑人的发病率（每年每 100 人 0.66 例，每 100 人每年 0.17 例）。 APK还预测吸毒者平均年龄将从35(±1)上升至40(±2)，30岁以上人口比例相应从59(±2)%上升至80(±6)%。我们的研究强调了分析亚人群在疾病预测中的重要性，计算机模拟在分析吸毒者人口和健康趋势方面的实用性，并作为指导芝加哥和其他主要城市的干预和预防策略的工具。
People who inject drugs (PWID) are at high risk for blood-borne pathogens transmitted during the sharing of contaminated injection equipment, particularly hepatitis C virus (HCV). HCV prevalence is influenced by a complex interplay of drug-use behaviors, social networks, and geography, as well as the availability of interventions, such as needle exchange programs. To adequately address this complexity in HCV epidemic forecasting, we have developed a computational model, the Agent-based Pathogen Kinetics model (APK). APK simulates the PWID population in metropolitan Chicago, including the social interactions that result in HCV infection. We used multiple empirical data sources on Chicago PWID to build a spatial distribution of an in silico PWID population and modeled networks among the PWID by considering the geography of the city and its suburbs. APK was validated against 2012 empirical data (the latest available) and shown to agree with network and epidemiological surveys to within 1%. For the period 2010–2020, APK forecasts a decline in HCV prevalence of 0.8% per year from 44(±2)% to 36(±5)%, although some sub-populations would continue to have relatively high prevalence, including Non-Hispanic Blacks, 48(±5)%. The rate of decline will be lowest in Non-Hispanic Whites and we find, in a reversal of historical trends, that incidence among non-Hispanic Whites would exceed incidence among Non-Hispanic Blacks (0.66 per 100 per years vs 0.17 per 100 person years). APK also forecasts an increase in PWID mean age from 35(±1) to 40(±2) with a corresponding increase from 59(±2)% to 80(±6)% in the proportion of the population >30 years old. Our studies highlight the importance of analyzing subpopulations in disease predictions, the utility of computer simulation for analyzing demographic and health trends among PWID and serve as a tool for guiding intervention and prevention strategies in Chicago, and other major cities.