HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact.
HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact.
复制标题
DOI：
10.1111/jvh.12338
复制
发表时间：
2015-04
影响因子：
2.5
通讯作者：
Hickman M
中科院分区：
文献类型：
--
作者：
Martin NK;Foster GR;Vilar J;Ryder S;Cramp ME;Gordon F;Dillon JF;Craine N;Busse H;Clements A;Hutchinson SJ;Ustianowski A;Ramsay M;Goldberg DJ;Irving W;Hope V;De Angelis D;Lyons M;Vickerman P;Hickman M
对注射吸毒者（PWID）进行丙型肝炎病毒（HCV）抗病毒治疗可以预防继续传播并减少慢性流行。我们评估了英国7个地区目前的PWID治疗率，并预测了当前和扩大治疗对HCV慢性患病率的潜在影响。收集了来自英国7个地区的PWID治疗人数和持续病毒反应率（SVR）数据：布里斯托尔（PWID中HCV慢性患病率为37-48%）、东伦敦（37-48%）、曼彻斯特（48-56%）、诺丁汉（37-44%）、普利茅斯（30-37%）、邓迪（20-27%）和北威尔士（27-33%）。PWID中HCV传播模型预测了(i)当前治疗率和SVR的10年影响（ii）无干扰素直接作用抗病毒药物（IFN-free DAAs）的SVR为90%。治疗率从每1000 PWID <5到超过25不等。PWID的合并意向治疗SVR为45%基因型1/4 [95%CI 33-57%]和61%基因型2/3 [95%CI 47-76%]。目前治疗水平10年后PWID中慢性HCV患病率的预测与目前HCV患病率的估计有很大的重叠。使用不含干扰素的DAAs将治疗规模扩大到每年26/1000 PWID（已经在两个地点实现），可以在所有地点的PWID中实现HCV慢性患病率至少15%的可观察到的绝对降低，并在十年内将普利茅斯、邓迪和北威尔士的慢性HCV患病率降低一半以上。在未来10年内，PWID目前的治疗率不太可能实现HCV慢性患病率的可观察到的降低。然而，可实现的扩大可导致丙型肝炎病毒慢性患病率大幅下降。
Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37–48% HCV chronic prevalence among PWID), East London (37–48%), Manchester (48–56%), Nottingham (37–44%), Plymouth (30–37%), Dundee (20–27%) and North Wales (27–33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33–57%] and 61% genotypes 2/3 [95%CI 47–76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence.
登录
查看更多内容
影响因子：
11.8
作者：
Alavi, Maryam;Grebely, Jason;Dore, Gregory J.
通讯作者：
Dore, Gregory J.
影响因子：
7.6
作者：
Jack, K.;Willott, S.;Thomson, B. J.
通讯作者：
Thomson, B. J.
DOI：
10.1136/bmj.c3172
发表时间：
2010-07-01
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Kimber J;Copeland L;Hickman M;Macleod J;McKenzie J;De Angelis D;Robertson JR
通讯作者：
Robertson JR
影响因子：
2.5
作者：
Irving, WL;Smith, S;Hippisley-Cox, J
通讯作者：
Hippisley-Cox, J
影响因子：
25.7
作者：
Harris, Ross J.;Thomas, Brenda;Harris, Helen E.
通讯作者：
Harris, Helen E.