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Is hepatitis C virus (HCV) elimination achievable among people who inject drugs in Tijuana, Mexico? A modeling analysis

dc.creatorMarquez, Lara K.es_ES
dc.creatorCepeda, Javier A.es_ES
dc.creatorBórquez, Annickes_ES
dc.creatorStrathdee, Steffanie A.es_ES
dc.creatorGonzalez-Zúñiga, Patricia E.es_ES
dc.creatorFleiz, Claraes_ES
dc.creatorRafful, Claudiaes_ES
dc.creatorGarfein, Richard S.es_ES
dc.creatorKiene, Susan M.es_ES
dc.creatorBrodine, Stephaniees_ES
dc.creatorMartin, Natasha K.es_ES
dc.date2020
dc.date.accessioned2023-08-28T17:26:35Z
dc.date.available2023-08-28T17:26:35Z
dc.date.issued2020
dc.identifierJC16DIEP20es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/7741
dc.identifier.urihttps://doi.org/10.1016/j.drugpo.2020.102710
dc.identifier.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133359/
dc.descriptionBackground: In 2019, Mexico became the first Latin American country committed to hepatitis C virus (HCV) elimination, but the amount of intervention scale-up required is unclear. In Tijuana, HCV among people who inject drugs (PWID) is high; yet there is minimal and intermittent harm reduction, and involuntary exposure to compulsory abstinence programs (CAP) occurs which is associated with increased HCV risk. We determined what combination intervention scale-up can achieve HCV elimination among current and former PWID in Tijuana. Methods: We constructed a dynamic, deterministic model of HCV transmission, disease progression, and harm reduction among current and former PWID parameterized to Tijuana (~10,000 current PWID, 90% HCV seropositive, minimal opiate agonist therapy [OAT] or high coverage needle/syringe programs [HCNSP]). We evaluated the number of direct-acting antiviral (DAA) treatments needed from 2019 to achieve elimination targets (80% incidence reduction, 65% mortality reduction by 2030) with: (a) DAAs alone, (b) DAAs plus scale-up of OAT+HCNSP (up to 50% coverage of OAT and HCNSP separately, producing 25% of PWID receiving both), (c) DAAs plus CAP scale-up to 50%. Scenarios examined the number of DAAs required if prioritized to current PWID or provided regardless of current injection status, and impact of harm reduction interruptions. Results: Modeling suggests among ~30,000 current and former PWID in Tijuana, 16,160 (95%CI: 12,770-21,610) have chronic HCV. DAA scale-up can achieve the incidence target, requiring 770 treatments/year (95%CI: 640-970) if prioritized to current PWID. 40% fewer DAAs are required with OAT+HCNSP scale-up to 50% among PWID, whereas more are required with involuntary CAP scale-up. Both targets can only be achieved through treating both current and former PWID (1,710 treatments/year), and impact is reduced with harm reduction interruptions. Conclusions: Elimination targets are achievable in Tijuana through scale-up of harm reduction and DAA therapy, whereas involuntary CAP and harm reduction interruptions hamper elimination.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherElsevieres_ES
dc.relation88:102710
dc.rightsAcceso Cerradoes_ES
dc.titleIs hepatitis C virus (HCV) elimination achievable among people who inject drugs in Tijuana, Mexico? A modeling analysises_ES
dc.typeArtículoes_ES
dc.contributor.affiliationDepartment of Family Medicine & Public Health, University of California San Diego, La Jolla, California, United States
dc.contributor.emaillkusnezo@mail.ucsd.edu (L.K. Marquez), jacepeda@ucsd.edu (J.A. Cepeda), aborquez@ucsd.edu (A. Bórquez), sstrathdee@ucsd.edu (S.A. Strathdee), pgonzalez-zuniga@ucsd.edu (P.E. Gonzalez-Zúñiga), fleiz@imp.edu.mx (C. Fleiz), crafful@comunidad.unam.mx (C. Rafful), rgarfein@ucsd.edu (R.S. Garfein), skiene@sdsu.edu (S.M. Kiene), sbrodine@sdsu.edu (S. Brodine), natasha-martin@ucsd.edu (N.K. Martin).
dc.relation.jnabreviadoINT J DRUG POLICY
dc.relation.journalInternational Journal on Drug Policy
dc.identifier.placePaíses Bajos
dc.date.published2020
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.doi10.1016/j.drugpo.2020.102710
dc.subject.kwHepatitis C elimination
dc.subject.kwModeling
dc.subject.kwPeople who inject drugs.


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