Previous Article in Journal
Genotypic Clustering of H5N1 Avian Influenza Viruses in North America Evaluated by Ordination Analysis
Previous Article in Special Issue
A Pilot Randomised Controlled Trial Involving Financial Incentives to Facilitate Hepatitis C Treatment Uptake Among People Who Inject Drugs: ETHOS Engage Study
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies

1
Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA 92093, USA
2
The Liver Coalition, San Diego, CA 92121, USA
3
Family Health Centers San Diego, San Diego, CA 92123, USA
4
County of San Diego Health and Human Services Agency, San Diego, CA 92123, USA
5
Harm Reduction Coalition San Diego, San Diego, CA 92101, USA
*
Author to whom correspondence should be addressed.
Viruses 2024, 16(12), 1819; https://doi.org/10.3390/v16121819
Submission received: 19 September 2024 / Revised: 5 November 2024 / Accepted: 8 November 2024 / Published: 22 November 2024
(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

Abstract

In 2020, the Eliminate Hepatitis C Initiative in the county of San Diego (COSD) was launched, a private–public joint endeavor between the COSD and the American Liver Foundation. We use epidemic modeling to assess whether the COSD is on track to reach its elimination targets (80% reduction in incidence, 65% reduction in hepatitis C virus (HCV)-related mortality by 2030 compared to 2015) and what intervention scale-up may be required. We adapted a previously developed dynamic, deterministic model of HCV transmission and disease progression among adults in the COSD, stratified by risk, age, gender, and human immunodeficiency virus (HIV) status. The model is calibrated to detailed historical epidemiological data on HCV burden, treatment, and mortality in the COSD. We project HCV infections and mortality under status quo HCV treatment (65%/year among people coinfected with HCV and HIV, 0–5%/year among others) and determine what treatment scale-up among those without HIV is required to achieve HCV elimination, with or without concomitant reductions in injection transmission risk from 2024 onward. We project an increase in new HCV infections in the COSD to 2213 [95% C.I.: 1069–3763] in 2030, a mean 91% relative increase between 2015 and 2030. HCV-related deaths are expected to decrease to 246 [95% C.I.: 180–295] in 2030, a mean relative decrease of 14% compared to 2015. The incidence elimination target could be achieved through increasing HCV treatment among those without HIV to a mean of 60%/year, similar to the level achieved among people coinfected with HCV and HIV. Combination interventions reduce the treatment needed; if injecting risk is reduced by 25%, then treating 48%/year could achieve elimination. The COSD is likely not on track to reach the incidence or mortality targets, but achieving the incidence target is possible if treatment rates overall are scaled-up to rates that have been achieved among people coinfected with HCV and HIV. Elimination is achievable but requires committed funding and expansion of comprehensive testing, linkage, and treatment programs alongside harm reduction initiatives.
Keywords: people who inject drugs; elimination; hepatitis c; testing; harm reduction people who inject drugs; elimination; hepatitis c; testing; harm reduction

Share and Cite

MDPI and ACS Style

Cheema, J.S.; Suckow, S.; Ramers, C.; Loose, P.; Tomada, A.; Tweeten, S.; Stamos-Buesig, T.; Abramovitz, D.; Eger, W.H.; Strathdee, S.A.; et al. Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies. Viruses 2024, 16, 1819. https://doi.org/10.3390/v16121819

AMA Style

Cheema JS, Suckow S, Ramers C, Loose P, Tomada A, Tweeten S, Stamos-Buesig T, Abramovitz D, Eger WH, Strathdee SA, et al. Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies. Viruses. 2024; 16(12):1819. https://doi.org/10.3390/v16121819

Chicago/Turabian Style

Cheema, Jaskaran S., Scott Suckow, Christian Ramers, Patrick Loose, Andrea Tomada, Samantha Tweeten, Tara Stamos-Buesig, Daniela Abramovitz, William H. Eger, Steffanie A. Strathdee, and et al. 2024. "Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies" Viruses 16, no. 12: 1819. https://doi.org/10.3390/v16121819

APA Style

Cheema, J. S., Suckow, S., Ramers, C., Loose, P., Tomada, A., Tweeten, S., Stamos-Buesig, T., Abramovitz, D., Eger, W. H., Strathdee, S. A., & Martin, N. K. (2024). Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies. Viruses, 16(12), 1819. https://doi.org/10.3390/v16121819

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop