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Loyola University Medical Center

Department of Medicine

Division of Hepatology

2160 S. First Ave
Mulcahy Center, Rm 1610

Maywood, IL 60153, USA

Email: hdahari@luc.edu

Phone: 708-216-4682

Fax: 708-216-6299

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

ARXIV

 June 2019

[Full Text]

Abstract

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.