Modeling HCV/HIV Transmission and TasP in US network of PWID

Hepatitis C virus (HCV) and HIV, respectively, are the two most prevalent chronic viral infections. Among the 1.2 million people living with HIV, 25-30% are HCV/HIV coinfected, but HCV prevalence is highest (80.8%) among HIV+ people who inject drugs (PWIDs). With the availability of more tolerable and better HCV treatments, a Treatment as Prevention (TasP) approach could drastically tip the balance towards increased and potentially targeted HCV treatment approaches. Though eradicating HCV will require a strategic combination of prevention AND treatment, HCV treatment costs may become staggering and require strategic targeting of PWIDs - the only ones who can transmit virus. Treating PWIDs most effectively, however, requires a better understanding of injecting networks and understanding such structures may help guide informed treatment strategies.

The specific aims of this study are to:

1) Simulate injection networks using a measurement-calibrated network model of injection partnerships based on secondary data recently completed from a large, U.S. respondent-driven sample (RDS) of PWIDs

2) Develop a HCV dynamic transmission model that incorporates injection network structures and agent-based simulations to achieve two goals to:

a) analyze the effect of injection network structure on HCV incidence and prevalence

b) evaluate the effectiveness of various HCV TasP strategies within US PWID injection networks.

Funding Provided by:
National Institute on Drug Abuse

Project Period:
2016 - 2018