Department of Population Science and Medical Statistics, Faculty of Medicine, C level, South Academic block, University of Southampton, Southampton, NH, United Kingdom.
Department of Mathematics, University of Southampton, Southampton, United Kingdom.
J Infect. 2020 Feb;80(2):225-231. doi: 10.1016/j.jinf.2019.12.010. Epub 2019 Dec 28.
To describe an injecting network of PWID living in an isolated community on the Isle of Wight (UK) and the results of a agent-based simulation, testing the effect of Hepatitis C (HCV) treatment on transmission.
People who inject drugs (PWID) were identified via respondent driven sampling and recruited to a network and bio-behavioural survey. The injecting network they described formed the baseline population and potential transmission pathways in an agent-based simulation of HCV transmission and the effects of treatment over 12 months.
On average each PWID had 2.6 injecting partners (range 0-14) and 137 were connected into a single component. HCV in the network was associated with a higher proportion of positive injecting partners (p = 0.003) and increasing age (p = 0.011). The treatment of well-connected PWID led to significantly fewer new infections of HCV than treating at random (10 vs. 7, p<0.001). In all scenarios less than one individual was re-infected.
In our model the preferential treatment of well-connected PWID maximised treatment as prevention. In the real-world setting, targeting treatment to actively injecting PWID, with multiple injecting partners may therefore represent the most efficient elimination strategy for HCV.
描述居住在英国怀特岛（Isle of Wight）一个隔离社区的注射吸毒者（PWID）网络，并对基于代理的 HCV 传播模拟试验结果进行测试。
通过应答者驱动抽样（RDS）识别吸毒者，并招募他们参与网络和生物行为调查。他们所描述的吸毒者网络构成了基于代理的 HCV 传播模拟中的基线人群和潜在传播途径，以及 12 个月内治疗的效果。
平均而言，每位吸毒者有 2.6 个注射伙伴（范围 0-14），137 人连接到一个单独的部分。网络中的 HCV 与更多阳性注射伙伴（p=0.003）和年龄增长（p=0.011）相关。与随机治疗相比，对联系紧密的吸毒者进行治疗可显著减少 HCV 的新感染（10 比 7，p<0.001）。在所有情况下，少于一个人再次感染。
在我们的模型中，对联系紧密的吸毒者进行优先治疗可最大限度地发挥治疗作为预防的效果。因此，在现实环境中，针对有多个注射伙伴的活跃吸毒者进行治疗，可能是 HCV 最有效的消除策略。
