Modelling the determinants and implications of the disparate trends in HCV and HIV amongst injecting drug users

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Public Health and Policy

Abstract

Hepatitis C (HCV) and HIV are viral infections that cause substantial morbidity and mortality amongst humans, with both infections being easily transmitted amongst injecting drug users when they share syringes. Reducing the ease with which they are propagated through injecting drug use is important for controlling their spread in most countries, with the main strategies for reducing transmission being the distribution of clean syringes, reducing their injecting frequency through supplying them with orally administered drug substitutes (frequently methadone), and other interventions seeking to reduce the frequency with which IDUs share syringes or inject. However, although there is evidence that these control strategies can reduce the rate of spread of HIV, there is little equivalent evidence for HCV. Indeed, this uncertainty and the fact that there is confusion over why certain populations of injecting drug users have much lower prevalences of HCV infection than others, has made it impossible for policy makers to produce clear guidelines on what coverage of specific control strategies is required to reduce the spread of these infections to a certain degree. This project plans to develop a mathematical model to simulate the time dependent trends in the prevalence of HCV and HIV infection of a number of injecting drug user populations experiencing different sizes of epidemic. The use of data from a number of sites will result in the model giving insights in to what aspects of the behaviour of injecting drug users was important for increasing the spread of the infections in certain settings, and so will identify what aspects of their behaviour could be focussed on to control their spread. The model will then be used to simulate the likely impact of different control strategies for reducing the spread of both infections amongst different populations of injecting drug users. Five control strategies will be simulated by the model, including the distribution of clean syringes, use of orally administered drug substitution therapy, educating injecting drug users to reduce risky behaviours, treating injecting drug users to cure their HCV infection, and providing treatment to delay the progression of HIV infection. The model projections will be used to help policy makers to produce targets for how much of a particular control strategy is needed to achieve a certain reduction in the spread of HIV and HCV infection in a particular population.

Technical Summary

Hepatitis C (HCV) and HIV cause substantial morbidity and mortality, with both infections being easily transmitted through infected syringes. Reducing the transmission of HCV and HIV through injecting drug use is critical to the overall prevention of these infections in most countries, with the main prevention strategies being syringe distribution, methadone substitution therapy, and other interventions seeking to reduce syringe sharing or injecting frequency. However, although there is evidence that these interventions can reduce HIV transmission, there is little equivalent evidence for HCV, and considerable confusion over why certain IDU populations have much smaller epidemics than others, and why IDU populations with very similar HIV prevalence can have widely different HCV prevalences. These gaps in our understanding has made it impossible for policy makers to develop clear guidelines on the scale of activity required to achieve substantial impact, or on what mix of interventions may be optimal. This project plans to use longitudinal HCV and HIV epidemiological and behavioural data from a number of IDU populations experiencing different types of epidemic to develop, fit and validate a joint model of HIV and HCV transmission. The data synthesis from a number of sites will provide informative data to inform model selection, validation and reduce parameter uncertainty. In addition, the differences between the model parameterisations for different settings will give pointers to what aspects of IDU risk behaviour may be associated with increased transmission, and so be focussed on by interventions. The different model fits will then be used to project the likely impact of different intervention activities for reducing the joint the transmission of HIV and HCV amongst IDUs in different HIV/HCV epidemics and at different stages of these epidemics. Five interventions will be considered ( syringe distribution, substitution therapy, risk reduction through outreach information and education, HCV treatment, and HIV treatment), and coverage and activity targets will be estimated for attaining specified reductions in HCV or HIV transmission.

Publications

10 25 50

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Hickman M (2011) Promoting recovery and preventing drug-related mortality: competing risks? in Journal of public health (Oxford, England)

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Hickman M (2015) Hepatitis C virus treatment as prevention in people who inject drugs: testing the evidence. in Current opinion in infectious diseases

 
Guideline Title ECDC-EMCDDA guidance report Prevention and control of infectious diseases among people who inject drugs
Description ECDC-EMCDDA guidance report
Geographic Reach Europe 
Policy Influence Type Citation in clinical guidelines
URL http://www.emcdda.europa.eu/publications/ecdc-emcdda-guidance
 
Description HCV treatment as prevention working group for European Monitoring Centre for Drugs and Drug Addiction
Geographic Reach Europe 
Policy Influence Type Participation in advisory committee
 
Description Influenced Scottish and Welsh policy makers in use of HCV antiviral treatment as prevention
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in advisory committee
 
Description Input into Belgium guidelines for preventing hepatitis C virus (HCV) amongst injectors
Geographic Reach Europe 
Policy Influence Type Citation in other policy documents
 
Description Modelling to feed into WHO guidance on prioritisation of anti-retroviral treatment for injecting drug users and HCV or HBV and HIV co-infected individuals
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in advisory committee
 
Description Undertaking economic analyses for NICE gidelines on how to increase testing for HCV and HBV
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
 
Description WHO guidance for improving surveillance and prevention of HCV and HBV amongst injectors
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in advisory committee
 
Description Assessing the impact and cost-effectiveness of needle/syringe provision on hepatitis C transmission among people who inject drugs: an analysis of pooled datasets and economic modelling
Amount £282,000 (GBP)
Funding ID 12/3070/13 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 10/2013 
End 11/2015
 
Description Cost-effectiveness of expanding ART provision to HBV co-infected individuals
Amount £26,110 (GBP)
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 08/2012 
End 12/2013
 
Description Cost-effectiveness of expanding ART provision to HCV co-infected indiviuals
Amount £10,300 (GBP)
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 08/2012 
End 12/2013
 
Description Cost-effectiveness of expanding ART provision to injecting drug users and men who have sex with men In India
Amount £21,189 (GBP)
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 08/2012 
End 12/2013
 
Description Economic Analysis to inform the development of NICE public health intervention guidance on 'Hepatitis B and C: ways to promote and offer testing to people at risk of infection'
Amount £125,420 (GBP)
Organisation National Institute for Health and Care Excellence (NICE) 
Sector Public
Country United Kingdom
Start 06/2011 
End 08/2012
 
Description Effectiveness and cost-effectiveness of hepatitis C screening and prevention programs
Amount £11,000 (GBP)
Organisation Belgian Health Care Knowledge Centre (KCE) 
Sector Public
Country Belgium
Start 02/2011 
End 10/2011
 
Description Impact of ART on HIV transmission amongst IDUs and FSWs in India
Amount $45,000 (USD)
Organisation Joint United Nations Programme on HIV/AIDS (UNAIDS) 
Sector Public
Country Global
Start 03/2012 
End 12/2013
 
Description Literature review of HCV and HBV co-infection globally
Amount £27,184 (GBP)
Organisation Bill and Melinda Gates Foundation 
Sector Charity/Non Profit
Country United States
Start 03/2012 
End 12/2013
 
Description NIH NIDA R01 call
Amount $500,000 (USD)
Funding ID R01 DA037773-01A1 
Organisation National Institutes of Health (NIH) 
Sector Public
Country United States
Start 04/2015 
End 03/2018
 
Description NIHR Postdoctoral Fellowship on 'Interventions to reduce hepatitis C virus transmission among injecting drug users'
Amount £260,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 10/2012 
End 04/2015
 
Description Programme Development grant on 'Can HCV treatment be delivered to injecting drug users in order to reduce HCV transmission and prevalence in the population: an empirical demonstration and evaluation'
Amount £97,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2011 
End 10/2012
 
Description Project grant for undertaking modelling to guide Scottish HCV action plan
Amount £55,000 (GBP)
Organisation Government of Scotland 
Sector Public
Country United Kingdom
Start 06/2012 
End 06/2013
 
Description Project grant for undertaking modelling to guide Scottish HCV action plan
Amount £100,000 (GBP)
Organisation Government of Scotland 
Sector Public
Country United Kingdom
Start 06/2009 
End 06/2011
 
Description Social, behavioral and transmission properties associated with diversity in HIV epidemics among people who inject drugs and other key populations
Amount $435,000 (CAD)
Funding ID 275499 
Organisation Canadian Institutes of Health Research 
Sector Public
Country Canada
Start 09/2013 
End 09/2016
 
Description Stratified Medicine to Optimise the Treatment of Patients with Hepatitis C Virus Infection (STOP HCV)
Amount £3,899,936 (GBP)
Funding ID MR/K01532X/1 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 04/2013 
End 04/2018
 
Description Technical Proposal for "Estimating cost-effectiveness for screening strategies for HBV, HCV and HIV infections in different populations in Europe"
Amount £30,000 (GBP)
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 03/2011 
End 12/2014
 
Title Economic model of impact of antiviral treatment on HCV transmission 
Description The model is in excel and estimates the increase in quality of life (QALYs) from providing antiviral treatment to active of ex- injecting drug users. The model suggests it is a highly cost-effective strategy. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact Paper has been published and has been of much interest to people interested in HCV prevention amongst injecting drug users: 21898506 Martin Natasha K (2011) The cost-effectiveness of HCV antiviral treatment for injecting drug user populations., Hepatology (Baltimore, Md.) 
 
Title Mathematical model of HCV co-infection in HIV infecteds 
Description The model has been used to understand how the sexual and injecting transmission of HIV in injecting drug users effects the prevalence of HCV amongst HIV infecteds. The model translates the HCV co-infection prevalence into an estimate for the proportion of HIV infections due to injecting. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact Work gained considerable interest when presented to EMCDDA and elsewhere. Paper submitted to AIDS: Vickerman, P. et al. Is the HCV/HIV co-infection prevalence amongst injecting drug users a marker for the level of sexual and injection related transmission of HIV? 
 
Title Mathematical model of HIV and HCV transmission 
Description A new model of HIV and HCV transmission amongst injecting drug users was developed. The model tracks the co-infection status of HIV and HCV and has enabled us to explore the interactions between these infections in a detailed way. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact Analyses are ongoing to explore the possible determinants for the different observed HIV and HCV epidemics that occur in different settings. This analysis is in press at DAD: Vickerman, Peter (00, 2011) Understanding the trends in HIV and hepatitis C prevalence amongst injecting drug users in different settings - implications for intervention impact, Drug and Alcohol Dependence In press, , Edit 
 
Title Mathematical model of effect of antiviral treatment on HCV transmission 
Description A model was developed to explore if antiviral treatment for HCV could be used to substantially reduce the prevalence and transmission of HCV. 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2010 
Provided To Others? Yes  
Impact 20832198 Vickerman Peter (2011) Can Hepatitis C virus treatment be used as a prevention strategy? Additional model projections for Australia and elsewhere., Drug and alcohol dependence 113, 2-3, 83-5; discussion 86-7 21145810 Martin Natasha K (2011) Can antiviral therapy for hepatitis C reduce the prevalence of HCV among injecting drug user populations? A modeling analysis of its prevention utility., Journal of hepatology 54, 6, 1137-44 21236265 Martin Natasha K (2011) Mathematical modelling of hepatitis C treatment for injecting drug users., Journal of theoretical biology 274, 1, 58-66 21853030 Martin Natasha K (2011) Optimal control of hepatitis C antiviral treatment programme delivery for prevention amongst a population of injecting drug users., PloS one 6, 8 21898506 Martin Natasha K (2011) The cost-effectiveness of HCV antiviral treatment for injecting drug user populations., Hepatology (Baltimore, Md.) The results have had substantial interest from policy makers in UK and Australia 
URL http://europepmc.org/abstract/MED/20832200
 
Title UK pooled HCV survey data for injecting drug users 
Description A number of bio-behavioural survey data sets were pooled from different settings in the UK to undertake an analysis on the risk factors for recent HCV infection amongst injecting drug users 
Type Of Material Biological samples 
Provided To Others? No  
Impact Analysis showed that opiate substitution therapy and high coverage needle and syringe distribution are associated with considerable decreases in HCV transmission risk. Paper was published in Addiction and has lead to a modelling analysis to consider the impact of scaling up these interventions on HCV prevalence 21615585 Turner Katy M E (2011) The impact of needle and syringe provision and opiate substitution therapy on the incidence of hepatitis C virus in injecting drug users: pooling of UK evidence., Addiction (Abingdon, England) 106, 11, 1978-88 
 
Description Collaboration with Beth Israel Deaconess Medical Center, New York 
Organisation Beth Israel Deaconess Medical Center
Department Baron Edmond de Rothschild Chemical Dependency Institute
Country United States 
Sector Academic/University 
PI Contribution I am modelling the transmission of HCV and HIV amongst injecting drug users in New York. The model is being used to discern how existing interventions have reduced HIV in this setting and the degree to which HIV is transmissted sexually through considering the HCV and HSV-2 co-infection prevalence amongst HIV infected IDUs.
Collaborator Contribution They have provided useful data on HIV and HCV prevalence from the epidemic amongst injecting drug users in New YorK. We have also submitted a paper considering whether HCV co-infection data can be used to estimate the porportion of HIV infections amongst injectors that are due to sexual transmission.
Impact We have submitted a paper considering the degree to which the HCV co-infection prevalence amongst HIV infected IDUs can be used to estimate the proportion of HIV infections that are sexually transmitted.
Start Year 2010
 
Description Collaboration with Burnet Institute, Melbourne 
Organisation Burnet Institute
Department Centre for Infection
Country Australia 
Sector Charity/Non Profit 
PI Contribution WIthin this collaboration I have modelled: 1. The effect HCV testing interval has on experimental estimates of HCV re-infection and clearance. 2. The role of combination interventions in preventing HIV transmission amongst injectors. I will also be modelling the transmission of HCV amongst injecting drug users in Melbourne to understand the contribution of immunity to their epidemic.
Collaborator Contribution They have provided data for modelling the possible immunity that exists amongst injecting drug users that have recovered from HCV infection, and for understanding the role HCV testing interval has on measures of HCv re-infection in IDUs
Impact I am joiontly supervising a PHD student that is using Bayesian MCMC techniques to estimate uinbiased estimates of HCV reinfection incidence and clearance from an International pooled dataset of cohort studies that done re-infection studies amongst IDUs. We have also published a number of papers from our collaboration and have other papers in review: 20650522 Degenhardt Louisa (Jul, 2010) Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed., Lancet 376, 9737, 285-301 Vickerman, Peter (2011) The more you look the more you find - Effects of hepatitis C virus testing interval on re-infection incidence and clearance: Implications for future vaccine study design, Journal of Infectious Diseases In press
Start Year 2009
 
Description Collaboration with European monitoring centre for Drug Dependence and Addiction 
Organisation European Monitoring Centre for Drugs and Drug Addiction
Country Belgium 
Sector Public 
PI Contribution We undertook a systematic review of the relationship between HIV and HCV prevalence in injecting drug user populations from different settings. The data from EMCDDA made up a substantial part of that data set.
Collaborator Contribution They have provided HIV, HCV and HIV/HCV co-infection prevalence data from a wide range of European settings over many years
Impact 19922515 Del Fava, Emanuele (2011) Joint Modeling of HCV and HIV Infections among Injecting Drug Users in Italy Using Repeated Cross-Sectional Prevalence Data, Statistical Communications in Infectious Diseases 3, 1 Vickerman, Peter (2011) Understanding the trends in HIV and hepatitis C prevalence amongst injecting drug users in different settings - implications for intervention impact, Drug and Alcohol Dependence In press
Start Year 2008
 
Description Collaboration with Health Protection Scotland 
Organisation NHS National Services Scotland (NSS)
Department Health Protection Scotland
Country United Kingdom 
Sector Public 
PI Contribution We have developed a model to estimate the impact of HCV treatment on the transmission of HCV in different settings. The model has recently been adapted to estimate the resulting cost-effectiveness of this strategy.
Collaborator Contribution Provision of data for modelling and pooled analysis of the effect of OST and NSP on HCv incidence. Also contributed to formulation of research ideas and writing of papers
Impact We are currently collaborating on trying to undertake a trial/study to evaluate HCV treatment as a prevention strategy in the field. We have also published a number of joint papers: 21145810 Martin Natasha K (2011) Can antiviral therapy for hepatitis C reduce the prevalence of HCV among injecting drug user populations? A modeling analysis of its prevention utility., Journal of hepatology 54, 6, 1137-44 21236265 Martin Natasha K (2011) Mathematical modelling of hepatitis C treatment for injecting drug users., Journal of theoretical biology 274, 1, 58-66 21615585 Turner Katy M E (2011) The impact of needle and syringe provision and opiate substitution therapy on the incidence of hepatitis C virus in injecting drug users: pooling of UK evidence., Addiction 106, 11, 1978-88 21898506 Martin Natasha K (2011) The cost-effectiveness of HCV antiviral treatment for injecting drug user populations., Hepatology (Baltimore, Md.)
Start Year 2009
 
Description Collaboration with Imperial College 
Organisation Imperial College London
Department Faculty of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution I will be supervising a modelling PhD
Collaborator Contribution We have just started to supervise a joint PhD student that will be undertaking modelling amongst injection drug users in Myanmar
Impact No outputs at present linked to this award
Start Year 2006
 
Description Collaboration with Kirby Institute, UNSW, Sydney, Australia 
Organisation University of New South Wales
Department Kirby Institute
Country Australia 
Sector Academic/University 
PI Contribution I have contributed to their work in using modelling to analyse their data in ways that they were unable to do.
Collaborator Contribution They have input into ongoing study ideas on using modelling to consider the impact of HCV treatment as prevention amongst IDUs. We have also worked on using modelling in connection with a large International pooled data set of cohort studies looking at HCV re-infection amongst IDUs. Further collaborations looking at the role that prison plays in promoting the transmission of HCV in different settings are underway.
Impact They are collaborators on a NIHR fellowship that was awarded to Natasha Martin in our group, we supervise a joint PhD student and we have a paper in press: Vickerman, Peter (2011) The more you look the more you find - Effects of hepatitis C virus testing interval on re-infection incidence and clearance: Implications for future vaccine study design, Journal of Infectious Diseases In press
Start Year 2010
 
Description Collaboration with University of Bristol 
Organisation University of Bristol
Department School of Social and Community Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been involved in numerous projects with UOB where modelling has been involved. This has resulted in over 10 co-authored papers, the recruitment of a joint research assistant to undertake mathematical modelling of HCV in the UK, and a joint PhD student that is using network modelling to consider the transmission of HCV and HIV in different settings.
Collaborator Contribution Provision of data for model analyses. Input into model analysis plans and co-authoring publications.
Impact 19922515 20978062 20832198 20650522 20627977 21145810 21236265 21615585 21853030 21898506 and Vickerman, Peter (2011) The more you look the more you find - Effects of hepatitis C virus testing interval on re-infection incidence and clearance: Implications for future vaccine study design, Journal of Infectious Diseases In press Vickerman, Peter (2011) Understanding the trends in HIV and hepatitis C prevalence amongst injecting drug users in different settings - implications for intervention impact, Drug and Alcohol Dependence In press
Start Year 2007
 
Description Collaboration with University of Hasselt 
Organisation University of Hasselt
Department Center for Statistics
Country Belgium 
Sector Academic/University 
PI Contribution Expert advise on an analysis they did following on from my review of HIV and HCv data published in Addiction. Also helping supervise a PhD student who is modelling HIV and HCV amongst injectors.
Collaborator Contribution We are jointly supervising a PhD student that is using statistical methods and modelling to understand the joint dynamics of HIV and HCV in different settings
Impact Del Fava, Emanuele (2011) Joint Modeling of HCV and HIV Infections among Injecting Drug Users in Italy Using Repeated Cross-Sectional Prevalence Data, Statistical Communications in Infectious Diseases 3, 1
Start Year 2010
 
Description Impact of anti-retroviral treatment and harm reduction interventions on transmission of HIV amongst injecting drug users in Manipur, Northern India 
Organisation Joint United Nations Programme on HIV/AIDS (UNAIDS)
Country Global 
Sector Public 
PI Contribution Undertaking mathematical modelling of the effect of anti-retroviral treatment and harm reduction interventions on the transmission of HIV and HCV amongst injecting drug users in two districts of Manipur, Northern India.
Collaborator Contribution They are the go between between us and NACO of the Government of India, and are guiding the research to enable it to have maximum policy influence on Indian policy.
Impact Funding from UNAIDS India and the Bill and Melinda Gates Foundation.
Start Year 2012
 
Description International Collaboration of Incident HIV and Hepatitis C in Injecting Cohorts Collaborative Group update 
Organisation Imperial College London
Department Department of Epidemiology and Biostatistics
Country United Kingdom 
Sector Academic/University 
PI Contribution I use modelling to help understand some of the trends in their data such as studies with longer HCv testing intervals having lower re-infection clearance rates.
Collaborator Contribution Access to International pooled cohort data on re-infection amongst injectors
Impact Vickerman, Peter (2011) The more you look the more you find - Effects of hepatitis C virus testing interval on re-infection incidence and clearance: Implications for future vaccine study design, Journal of Infectious Diseases In press
Start Year 2010
 
Description Modelling of HCV and HIV transmission dynamics in Tijuana, Mexico 
Organisation University of California, San Diego (UCSD)
Department Global Health Institute (GHI)
Country United States 
Sector Academic/University 
PI Contribution We are undertaking modelling of the HIV epidemic amongst different high risk groups in Tijuana
Collaborator Contribution We are undertaking modelling and joint PI of project
Impact A paper is in press at Addiction.
Start Year 2015
 
Description Modelling of HCV in US and Pakistan with US Centre for Disease Control 
Organisation Centers for Disease Control and Prevention (CDC)
Department Division of Viral Hepatitis
Country Georgia 
Sector Public 
PI Contribution We initiated new modeling to consider the transmission of HCV in USA and Pakistan, and impact of prevention and treatment intervention
Collaborator Contribution We undertook modelling
Impact Presentation at EASL conference and CDC HCV conference
Start Year 2015
 
Description Social, behavioral and transmission properties associated with diversity in HIV epidemics among people who inject drugs and other key populations 
Organisation University of Manitoba
Department Population and Public Health
Country Canada 
Sector Academic/University 
PI Contribution We are the lead mathematical modellers undertaking the modelling component of this project
Collaborator Contribution They have undertaken four rounds of bio-behavioural surveys amongst high-risk groups in different cities of Pakistan.
Impact This collaboration has lead to funding from the Canadian Instutute of health research. The research is multi-disciplinary involving modelling and epidemicological research.
Start Year 2012
 
Title HCV antiviral treatment for prevention of HCV transmission amongst injecting drug users 
Description Through modelling we evaluated the use of an existing treatment (antiviral treatment for HCV infection) that can cure HCV infection for reducing the transmission of HCV amongst injecting drug users. The impact and cost-effectiveness results have been published in Journal of Hepatology and Hepatology. Since then we have been successful in obtaining further funding from NIHR (research fellowship for further modelling and program development grant for undertaking field studies) and Helath protection Scotland to progress this concept further. Additional interest has also been shown from Jannssen for undertaking a study in a number of Uk settings 
Type Therapeutic Intervention - Drug
Current Stage Of Development Initial development
Year Development Stage Completed 2010
Development Status Actively seeking support
Impact The results of the analysis has lead the HCV action plan for Wales and Scotland to actively include HCV treatment of injecting drug users in their strategies and both plan to evaluate its effect. It has also been included in the guidaance for Balgium government and from ECDC. 
 
Description College on Problems of Drug Dependence 2011 Symposium (Miami) - Frontiers in systems modelling: bridging science and policy 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Presentation on 'Primary prevention of hepatitis C in injecting drug users and population: modelling the impact and role of opiate substitution treatment, needle exchange and HCV antiviral treatment'

None as yet
Year(s) Of Engagement Activity 2011
 
Description Invited presentation to 'Hepatitis C and Liver Disease Prevention Event' in Bristol 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Invited presentation on 'Preventing hepatitis C - treatment'. Lead to lengthy discussion about improving access to HCV treatment in Bristol.



None as yet
Year(s) Of Engagement Activity 2011
 
Description Invited presentation to 'Sussex Hepatology Network on using HCV treatment for prevention' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact Presentation on 'Hepatitis C prevention: modeling the impact and cost-effectiveness of antiviral therapy'. Presentation resulted in a discussion about improving treatment services in Sussex deanery.


None as yet
Year(s) Of Engagement Activity 2011
 
Description Invited presentations at 'European Monitoring Centre for Drugs and Drug Addiction' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Invited presentations on 1. 'HCV antiviral treatment as prevention' and 2. 'Can HCV co-infection prevalence amongst HIV infected IDUs be used as a marker of sexual HIV transmission?' 3. 'Initial model analyses of the joint epidemiology of HCV and HIV amongst injecting drug users '. As a result, presentation was given to EU and sparked extended debate.

EMCDDA has initiated a working group considering HCV treatment as prevention. Meeting due to be held in Lisbon in April 2012.
Year(s) Of Engagement Activity 2008,2009,2010
 
Description Keynote speech to 'National Needle Exchange Forum Conference', Bristol 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation on 'Hepatitis C Prevention: Needle Exchange and Other Interventions'. Lead to discussion about improving treatment through addiction services.


None as yet
Year(s) Of Engagement Activity 2011
 
Description Plenary presentation at 'HIV in European Region - Unity and Diversity' conference, Tallinn 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Presentation on 'Impact of syringe exchange programmes and opiate substitution therapy to prevent HIV and HCV transmission among IDUs.'

None as yet
Year(s) Of Engagement Activity 2011
 
Description Plenary presentation at the 'National Conference on injecting drug use', Newcastle 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Health professionals
Results and Impact Considerable debate on the use of HCV antiviral treatment for prevention.

None at present
Year(s) Of Engagement Activity 2010
 
Description Presentaion at 'ECDC-EMCDDA Launch of guidance. Prevention and control of infectious diseases among people who inject drugs.' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Presentation on 'Primary prevention of HCV'. Influenced guidance document from EMCDDA/ECDC.

EMCDDA is initiating a group to discuss guidance for using HCV treatment as prevention
Year(s) Of Engagement Activity 2011
 
Description Presentation at '4th National Conference: Addiction and the Liver 2011.' London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Presentation on 'Primary prevention of HCV'.

None as yet
Year(s) Of Engagement Activity 2011
 
Description Presentation at 'Agence Nationale de Recherche sur le Sida et les hepatites virales (ANRS)' meeting. Paris 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Health professionals
Results and Impact Presentation on 'Modelling hepatitis C prevention: OST, NSP, and treatment'. Extensive discussion on HCV treatment for prevention. Plan is to apply for collaboration grant to undertake epidemiological study to explore impact of HCV treatment for prevention.

None as yet
Year(s) Of Engagement Activity 2011
 
Description Presentation at 'Annual Colloquium of Centre for Research Excellence into injecting drug use', Burnet Institute, Melbourne 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Health professionals
Results and Impact Presentation on 'Prevention of HCV transmission: Can it be done?' and 'Can antiviral therapy for HCV be a prevention tool for active IDUs? A modelling analysis'. Talk lead to indepth discussion of feasibility of using HCV antiviral treatment as a prevention strategy in Australia.

Had meeting with Health Minister for Victoria who was wanting to decide how to allocate a numbe rof new Hepatology nurses. Some of the nurses have been allocated to drug addiction centres
Year(s) Of Engagement Activity 2010,2011
 
Description Presentation at 'Hepatitis C, Substance Misuse and Health Inequalities: Delivering a Consensus for London' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Gave a talk on 'The Utility of Antiviral Treatment for Primary Prevention of Hepatitis C'. Resulted in the development a consensus statement outlining a cohesive plan for better hepatitis C treatment and care pathways in London for injecting drug users-- this document included a section on hepatitis C treatment as prevention and includes a figure from our slides. The consensus statement was presented to public health commissioners.


none as yet
Year(s) Of Engagement Activity 2010
 
Description Presentation at 'Welsh Action Plan Treatment and Care Subgroup' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation on 'Can antiviral therapy for HCV reduce prevalence among active IDUs? A modeling analysis'. Marion Lyons (Consultant in Communicable Disease Control) urged the representatives from each deanery in Wales to increase testing and treatment of IDUs.


A number of hepatology nurses have been employed and increased emphasis is being placed on treating IDUs.
Year(s) Of Engagement Activity 2010
 
Description Presentation to 'Belgium Institute for Tropical Medicine Episeminary' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Health professionals
Results and Impact Presentation on 'The impact and cost-effectiveness of hepatitis C antiviral treatment for prevention among injecting drug users.' Lead to us being involved in their National guidance on the strategies to prevent HCV transmission.


None as yet
Year(s) Of Engagement Activity 2011
 
Description Presentation to 'Health Protection Scotland' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Health professionals
Results and Impact Gave two talks on 'Can needle and syringe programmes and opiate substitution therapy achieve further reductions in HCV prevalence in a high coverage setting?' and 'Impact and cost-effectiveness of antiviral HCV treatment for prevention amongst IDUs'. Lead to extended discusssion about undertaking a trial to evaluate impact of HCV treatment for prevention amongst IDUs in Scotland and England.

We were granted further funding off HPS (£55,000) to undertake further modelling in this area, specifically aimed at considering specific sites that could be trial sites. Meeting with Jannsen is arranged for January 2012 to discuss their involvement.
Year(s) Of Engagement Activity 2010,2011
 
Description Presentation to 'Hepatitis C Action Plan Scotland Stakeholder Event, Glasgow' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation on 'Can HCV treatment of active injecting drug users (IDUs) lead to a reduction in HCV transmission?'. Action plan has actively scaled up HCV treatment for injectors in Scotland and initial plans are underway to undertake a trial to consider the impact of HCV treatment for prevention in Dundee.


Initial discussions are underway with Jannsen about undertaking trial - 'HCV educational meeting' is being organized by Jannsen for 26 Jan 2012. We will be presenting on impact of HCV treatment for prevention.
Year(s) Of Engagement Activity 2010
 
Description Prevention of HCV transmission: Can it be done? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact Invited talk to 70 health professionals in portsmouth on HCV prevention and modelling insights. There was considerable interest and good feedback from the talk.

None
Year(s) Of Engagement Activity 2012
 
Description Two presentations at '2nd International Symposium on Hepatitis Care in Substance Users', Brussels 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Two presentations on 'Can HCV antiviral therapy be used for prevention? Modelling impact, cost-effectiveness, and heterogeneity.' and 'Can needle and syringe programmes and opiate substitution therapy achieve further reductions in HCV prevalence in a high coverage setting?'. Talks lead to discussion session on feasibility of HCv treatment for prevention.

None as yet
Year(s) Of Engagement Activity 2011
 
Description Two presentations at 'Simulation Models of Infectious Disease Transmission and Control Processes (SIMID) Workshop' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Two talks on 'Modelling hepatitis C antiviral treatment for prevention amongst injecting drug users: impact and heterogeneity' and 'Can HCV co-infection prevalence amongst HIV infected injecting drug users be used as a marker of sexual HIV transmission?'. Lead to being asked to be involved as expert consultants on Belgian Health Care Knowledge Centre (KCE) project considering "Effectiveness and cost-effectiveness of hepatitis C screening and prevention programs."

Report will be published on website: kce.fgov.be
Year(s) Of Engagement Activity 2011