Department of Ecology and Evolutionary Biology, Brown University, Providence, RI 02906, USA.
Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32827, USA.
J R Soc Interface. 2019 Sep 27;16(158):20190334. doi: 10.1098/rsif.2019.0334. Epub 2019 Sep 4.
The hepatitis C virus (HCV) epidemic often occurs through the persistence of injection drug use. Mathematical models have been useful in understanding various aspects of the HCV epidemic, and especially, the importance of new treatment measures. Until now, however, few models have attempted to understand HCV in terms of an interaction between the various actors in an HCV outbreak-hosts, viruses and the needle injection equipment. In this study, we apply perspectives from the ecology of infectious diseases to model the transmission of HCV among a population of injection drug users. The products of our model suggest that modelling HCV as an indirectly transmitted infection-where the injection equipment serves as an environmental reservoir for infection-facilitates a more nuanced understanding of disease dynamics, by animating the underappreciated actors and interactions that frame disease. This lens may allow us to understand how certain public health interventions (e.g. needle exchange programmes) influence HCV epidemics. Lastly, we argue that this model is of particular importance in the light of the modern opioid epidemic, which has already been associated with outbreaks of viral diseases.
丙型肝炎病毒 (HCV) 流行通常是通过持续注射吸毒引起的。数学模型在理解 HCV 流行的各个方面非常有用，尤其是在理解新的治疗措施方面。然而，到目前为止，很少有模型试图从 HCV 爆发中各个参与者（宿主、病毒和注射针具）之间的相互作用的角度来理解 HCV。在这项研究中，我们应用传染病生态学的观点来对注射吸毒者人群中的 HCV 传播进行建模。我们模型的结果表明，将 HCV 建模为一种间接传播的感染，其中注射设备充当感染的环境储库，通过激活被低估的参与者和相互作用来促进对疾病动态更细致入微的理解。这种视角可以帮助我们理解某些公共卫生干预措施（例如，针具交换计划）如何影响 HCV 流行。最后，我们认为，鉴于现代阿片类药物流行已经与病毒疾病的爆发有关，因此该模型具有特别重要的意义。
