Evaluating the Population Impact of Hepatitis C Direct Acting Antiviral Treatment as Prevention for People Who Inject Drugs
Prior to our programme grant, it was estimated that 200,000 people in the UK have been infected with the Hepatitis C Virus (HCV), which is an important cause of liver disease, cancer and death. Most HCV infections in the UK are in people who inject drugs (PWID). New HCV drugs (Direct Acting Antivirals (DAAs)) cure over 90% of patients within 12 weeks with few side-effects. Recent price reductions combined with removal of previous restrictions to prioritise treatment to people with severe liver disease affords opportunity to substantially scale-up HCV treatment.
Mathematical models suggest that HCV Treatment as Prevention (TasP), i.e. treating people who inject drugs and have mild liver disease for HCV, is cost-effective and can reduce the overall number of new HCV infections in the population and achieve greater reductions in HCV transmission in combination with other primary prevention interventions, such as Opioid Agonist Treatment (OAT) and Needle and Syringe Programmes (NSP). The evidence is summarised in the protocol paper.
EPIToPe aims to generate UK empirical evidence on the effectiveness of HCV 'Treatment as Prevention' in people who inject drugs. The programme consists of 5 workstreams.
WS3 have produced a Set of Recommendations (PDF, 883kB) for scaling up HCV testing and treatment for People Who Inject Drugs from interviews with service users and providers.
After submission of the checkpoint progress report, NIHR have agreed to the release of the time and funds for the remaining components of the programme.