Agent-based modeling of persons who inject drugs in metropolitan Chicago suggests that re-treatment with antivirals of persons who are re-infected with Hep C is critical to achieve the WHO incidence reduction objective by 2030

Eric Tatara, Alexander Gutfraind, Nicholson T. Collier, Scott J. Cotler, Marian Major, Basmattee Boodram, Jonathan Ozik, Harel Dahari


 June 2019

[Full Text]


Hepatitis C (HCV) is a leading cause of chronic liver disease and mortality worldwide. Persons who inject drugs (PWID) are at the highest risk for acquiring and transmitting HCV infection. We developed an agent-based model (ABM) to identify and optimize direct-acting antiviral (DAA) therapy scale-up and treatment strategies for achieving the World Health Organization (WHO) goals of HCV elimination by the year 2030. DAA is highly efficacious, but may require re-treatment particularly among PWID who at risk for reinfection after cure. Using an ABM approach, we predict that this prohibition will jeopardize achieving the WHO’s goal of reducing 90% of HCV incidence by 2030.  We found that DAA scale-up rates of greater than or equal to 5% per year can achieve the WHO target of 90% incidence reduction. Our model simulations underscore the importance of DAA scale-up that includes re-treatment of re-infected individuals in order to achieve significant reductions in incidence.

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Loyola University Medical Center

Department of Medicine

Division of Hepatology

2160 S. First Ave
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Maywood, IL 60153, USA


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