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Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland
BACKGROUND AND AIMS: People who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. In Scotland, national survey data indicate lower HCV incidence in prison than the community (4.3 versus 7.3 per 1...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461206/ https://www.ncbi.nlm.nih.gov/pubmed/28257600 http://dx.doi.org/10.1111/add.13783 |
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author | Stone, Jack Martin, Natasha K. Hickman, Matthew Hutchinson, Sharon J. Aspinall, Esther Taylor, Avril Munro, Alison Dunleavy, Karen Peters, Erica Bramley, Peter Hayes, Peter C. Goldberg, David J. Vickerman, Peter |
author_facet | Stone, Jack Martin, Natasha K. Hickman, Matthew Hutchinson, Sharon J. Aspinall, Esther Taylor, Avril Munro, Alison Dunleavy, Karen Peters, Erica Bramley, Peter Hayes, Peter C. Goldberg, David J. Vickerman, Peter |
author_sort | Stone, Jack |
collection | PubMed |
description | BACKGROUND AND AIMS: People who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. In Scotland, national survey data indicate lower HCV incidence in prison than the community (4.3 versus 7.3 per 100 person‐years), but a 2.3‐fold elevated transmission risk among recently released (< 6 months) PWID. We evaluated the contribution of incarceration to HCV transmission among PWID and the impact of prison‐related prevention interventions, including scaling‐up direct‐acting antivirals (DAAs) in prison. DESIGN: Dynamic mathematical modelling of incarceration and HCV transmission, using approximate Bayesian computation for model calibration. SETTING: Scotland, UK. PARTICIPANTS: A simulated population of PWID. MEASUREMENTS: Population‐attributable fraction (PAF) of incarceration to HCV transmission among PWID. Decrease in HCV incidence and chronic prevalence due to current levels of prison opiate substitution therapy (OST; 57% coverage) and HCV treatment, as well as scaling‐up DAAs in prison and/or preventing the elevated risk associated with prison release. FINDINGS: Incarceration contributes 27.7% [PAF; 95% credible interval (CrI) –3.1 to 51.1%] of HCV transmission among PWID in Scotland. During the next 15 years, current HCV treatment rates (10.4/6.8 per 1000 incarcerated/community PWID annually), with existing prison OST, could reduce incidence and chronic prevalence among all PWID by a relative 10.7% (95% CrI = 8.4–13.3%) and 9.7% (95% CrI = 7.7–12.1%), respectively. Conversely, without prison OST, HCV incidence and chronic prevalence would decrease by 3.1% (95% CrI = –28.5 to 18.0%) and 4.7% (95% CrI = –11.3 to 14.5%). Additionally, preventing the heightened risk among recently released PWID could reduce incidence and chronic prevalence by 45.0% (95% CrI = 19.7–57.5%) and 33.3% (95% CrI = 15.6–43.6%) or scaling‐up prison HCV treatments to 80% of chronic PWID prison entrants with sufficient sentences (>16 weeks) could reduce incidence and prevalence by 45.6% (95% CrI = 38.0–51.3%) and 45.5% (95% CrI = 39.3–51.0%), respectively. CONCLUSIONS: Incarceration and the elevated transmission risk following prison release can contribute significantly to hepatitis C virus transmission among people who inject drugs. Scaling‐up hepatitis C virus treatment in prison can provide important prevention benefits. |
format | Online Article Text |
id | pubmed-5461206 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-54612062017-07-10 Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland Stone, Jack Martin, Natasha K. Hickman, Matthew Hutchinson, Sharon J. Aspinall, Esther Taylor, Avril Munro, Alison Dunleavy, Karen Peters, Erica Bramley, Peter Hayes, Peter C. Goldberg, David J. Vickerman, Peter Addiction HCV Series BACKGROUND AND AIMS: People who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. In Scotland, national survey data indicate lower HCV incidence in prison than the community (4.3 versus 7.3 per 100 person‐years), but a 2.3‐fold elevated transmission risk among recently released (< 6 months) PWID. We evaluated the contribution of incarceration to HCV transmission among PWID and the impact of prison‐related prevention interventions, including scaling‐up direct‐acting antivirals (DAAs) in prison. DESIGN: Dynamic mathematical modelling of incarceration and HCV transmission, using approximate Bayesian computation for model calibration. SETTING: Scotland, UK. PARTICIPANTS: A simulated population of PWID. MEASUREMENTS: Population‐attributable fraction (PAF) of incarceration to HCV transmission among PWID. Decrease in HCV incidence and chronic prevalence due to current levels of prison opiate substitution therapy (OST; 57% coverage) and HCV treatment, as well as scaling‐up DAAs in prison and/or preventing the elevated risk associated with prison release. FINDINGS: Incarceration contributes 27.7% [PAF; 95% credible interval (CrI) –3.1 to 51.1%] of HCV transmission among PWID in Scotland. During the next 15 years, current HCV treatment rates (10.4/6.8 per 1000 incarcerated/community PWID annually), with existing prison OST, could reduce incidence and chronic prevalence among all PWID by a relative 10.7% (95% CrI = 8.4–13.3%) and 9.7% (95% CrI = 7.7–12.1%), respectively. Conversely, without prison OST, HCV incidence and chronic prevalence would decrease by 3.1% (95% CrI = –28.5 to 18.0%) and 4.7% (95% CrI = –11.3 to 14.5%). Additionally, preventing the heightened risk among recently released PWID could reduce incidence and chronic prevalence by 45.0% (95% CrI = 19.7–57.5%) and 33.3% (95% CrI = 15.6–43.6%) or scaling‐up prison HCV treatments to 80% of chronic PWID prison entrants with sufficient sentences (>16 weeks) could reduce incidence and prevalence by 45.6% (95% CrI = 38.0–51.3%) and 45.5% (95% CrI = 39.3–51.0%), respectively. CONCLUSIONS: Incarceration and the elevated transmission risk following prison release can contribute significantly to hepatitis C virus transmission among people who inject drugs. Scaling‐up hepatitis C virus treatment in prison can provide important prevention benefits. John Wiley and Sons Inc. 2017-03-03 2017-07 /pmc/articles/PMC5461206/ /pubmed/28257600 http://dx.doi.org/10.1111/add.13783 Text en © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | HCV Series Stone, Jack Martin, Natasha K. Hickman, Matthew Hutchinson, Sharon J. Aspinall, Esther Taylor, Avril Munro, Alison Dunleavy, Karen Peters, Erica Bramley, Peter Hayes, Peter C. Goldberg, David J. Vickerman, Peter Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title | Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title_full | Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title_fullStr | Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title_full_unstemmed | Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title_short | Modelling the impact of incarceration and prison‐based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland |
title_sort | modelling the impact of incarceration and prison‐based hepatitis c virus (hcv) treatment on hcv transmission among people who inject drugs in scotland |
topic | HCV Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461206/ https://www.ncbi.nlm.nih.gov/pubmed/28257600 http://dx.doi.org/10.1111/add.13783 |
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