Leveraging HCV Phylogenetic Networks to Prevent HIV and Other Blood Borne Infections Among People Who Inject Drugs

利用 HCV 系统发育网络预防注射吸毒者中的 HIV 和其他血源性感染

• 批准号: 10238557
• 负责人: Matthew Akiyama
• 金额: $ 252万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10238557
• 关键词: AIDS prevention; Adult; Africa; Behavioral; Blood; Complex; Development; Drug Modelings; Drug Monitoring; Epidemic; Epidemiology; Essential Drugs; Genetic Variation; Goals; HIV; HIV Infections; Harm Reduction; Hepatitis B Virus; Hepatitis C virus; Incidence; Infection; Infection prevention; Injecting drug user; International; Kenya; Logistics; Modeling; Molecular; Morbidity - disease rate; Needles; Pharmaceutical Preparations; Phylogenetic Analysis; Policies; Policy Maker; Prevention; Prevention approach; Public Health; Research Personnel; Resources; Risk Factors; Services; Syringes; Update; Ursidae Family; Viral hepatitis; cost; geographic risk; high risk; innovation; low and middle-income countries; marginalized population; medication-assisted treatment; mortality; opioid use disorder; prevent; programs; prospective; public health intervention; scale up; social factors; tool; transmission process; virology

ABSTRACT HIV remains a significant cause of morbidity and mortality among people who inject drugs (PWID). Between 2011 and 2017, new HIV infections among adults worldwide declined by 14%; however, there has been no decrease in the annual number of new HIV infections among PWID. In fact, the incidence appears to be rising. PWID also bear a disproportionately high burden of other blood borne infections including HCV and HBV. In an update to the 90-90-90 HIV treatment targets, the HIV epidemic by 2030. Similarly, WHO has threat by 2030. To achieve UNAIDS and WHO’s targets, innovative strategies will be required among marginalized populations such as PWID, especially in low- and middle-income countries (LMICs) where coverage of UNAIDS issued a declaration of commitment to e nd called for elimination of viral hepatitis as a major public health needle and syringe programs and medication-assisted therapy may be limited. The overarching goal of this proposal is to inform a targeted public health strategy to prevent transmission of HIV and other blood borne infections among PWID. To accomplish this, we will leverage the high transmissibility and genetic diversity of HCV to identify PWID who are of high centrality in transmission networks in Kenya, East Africa. We will then determine demographic, behavioral, virologic, and geographic risk factors and model the impact of public health interventions targeted toward high centrality PWID on transmission of HIV and other blood borne infections. The strategy we propose aims to meet a critical need by supplying new molecular epidemiologic tools to inform development and revision of national and international strategies that can maximize the impact of prevention efforts for HIV and other blood borne infections. We expect this study to provide essential information for policy makers and researchers seeking to identify key priorities and strategies for blood borne infection prevention in settings where HIV and viral hepatitis epidemics are converging among PWID. In addition to providing evidence with immediate relevance to policy, the approach developed in this study will provide a durable template for further analyses, including prospective assessment of other targeted HIV prevention and HCV elimination strategies among PWID; and monitoring of progress towards key goals for reducing the burden of HIV, HCV, and other blood borne infections among PWID in resource limited settings.

摘要 艾滋病毒仍然是注射吸毒者发病和死亡的一个重要原因。之间 2011年和2017年，全球成年人艾滋病毒新发感染下降了14%;然而， 艾滋病毒/艾滋病感染者中每年新感染艾滋病毒的人数减少。事实上， 升中国PWID还承担着其他血液传播感染（包括HCV）的不成比例的高负担， 乙肝病毒。在90-90-90艾滋病毒治疗目标的更新中， 到2030年，艾滋病同样，世卫组织 2030年的威胁。为了实现艾滋病规划署和世卫组织的目标， 贫困人口等边缘化人群，特别是在中低收入国家， 覆盖 联合国艾滋病规划署发表了一项承诺宣言， 呼吁消除病毒性肝炎作为一个主要的公共卫生 针头和注射器程序以及药物辅助治疗可能受到限制。总体 该提案的目标是为有针对性的公共卫生战略提供信息，以预防艾滋病毒和其他 PWID中的血液传播感染。为了实现这一目标，我们将利用高传染性和遗传性 丙型肝炎病毒的多样性，以确定PWID谁是在肯尼亚，东非的传播网络的高度集中。我们 然后将确定人口统计学、行为学、病毒学和地理风险因素，并模拟 针对艾滋病毒和其他血液传播的高中心性PWID的公共卫生干预措施 感染.我们提出的战略旨在通过提供新的分子流行病学， 为制定和修订国家和国际战略提供信息的工具， 艾滋病毒和其他血液传播感染的预防工作。我们希望这项研究能够提供必要的 为政策制定者和研究人员提供的信息， 在艾滋病毒和病毒性肝炎流行病在PWID中汇合的环境中预防感染。在 除了提供与政策直接相关的证据外，本研究中开发的方法还将 为进一步分析提供持久的模板，包括对其他目标艾滋病毒的前瞻性评估 预防和消除艾滋病病毒感染者的战略;监测实现以下关键目标的进展情况： 在资源有限的情况下，减少艾滋病毒、丙型肝炎病毒和其他血液传播感染对残疾人的负担。

项目成果

High HCV cure rates among people who inject drugs and have suboptimal adherence: A patient-centered approach to HCV models of care.

• DOI: 10.1016/j.drugpo.2021.103135
• 发表时间: 2021-07
• 期刊: The International journal on drug policy
• 作者: Norton BL;Akiyama MJ;Arnsten JH;Agyemang L;Heo M;Litwin AH
• 通讯作者: Litwin AH

HIV And HCV adherence and treatment outcomes among people who inject drugs receiving opioid agonist therapy.

• DOI: 10.1080/09540121.2021.1973659
• 发表时间: 2022-10
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: J Minhas H;Akiyama MJ;Norton BL;Heo M;Arnsten JH;Litwin AH
• 通讯作者: Litwin AH

Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya.

在肯尼亚，接受同行病例管理者支持的直接观察治疗的注射药物患者中，丙型肝炎治愈的预测因素。

• DOI: 10.1016/j.drugpo.2023.103959
• 发表时间: 2023
• 期刊: The International journal on drug policy
• 作者: Akiyama,MatthewJ;Riback,LindseyR;Nyakowa,Mercy;Musyoki,Helgar;Lizcano,JohnA;Muller,Abbe;Zhang,Chenshu;Walker,JosephineG;Stone,Jack;Vickerman,Peter;Cherutich,Peter;Kurth,AnnE
• 通讯作者: Kurth,AnnE

Utilizing patient perception of group treatment in exploring medication adherence, social support, and quality of life outcomes in people who inject drugs with hepatitis C.

• DOI: 10.1016/j.jsat.2021.108459
• 发表时间: 2021-07
• 期刊: Journal of substance abuse treatment
• 影响因子: 3.9
• 作者: Howard KA;Rennert L;Pericot-Valverde I;Heo M;Norton BL;Akiyama MJ;Agyemang L;Litwin AH
• 通讯作者: Litwin AH

Impact of COVID-19 on substance use disorder treatment services in Kenya: Qualitative findings from healthcare providers.

COVID-19对肯尼亚药物使用障碍治疗服务的影响：医疗保健提供者的定性发现。

• DOI: 10.1016/j.drugpo.2022.103710
• 发表时间: 2022-07
• 期刊: INTERNATIONAL JOURNAL OF DRUG POLICY
• 影响因子: 4.4
• 作者: Muller, Abbe;Akiyama, Matthew J.;Riback, Lindsey;Nyakowa, Mercy;Musyoki, Helgar;Cherutich, Peter;Kurth, Ann
• 通讯作者: Kurth, Ann