Sharon Hutchinson is a Professor of Epidemiology and Population Health at Glasgow Caledonian University and Honorary Consultant with Public Health Scotland. Her research focusses on the evaluation of interventions to prevent blood-borne viruses and related harms among people who inject drugs. Her work has particularly helped to inform and monitor Scotland’s elimination strategy on Hepatitis C. With UK partners, she co-led the NIHR research project ‘Evaluating the population impact of hepatitis C direct-acting antiviral treatment as prevention for people who inject drugs’ (EPIToPe).

Abstract

Public health surveillance and statistical modelling of HCV TasP

Infection with Hepatitis C Virus (HCV) can lead to liver cirrhosis/cancer. HCV direct-acting antivirals (DAAs) cure over 90% of patients. This led WHO to set a global goal to eliminate HCV as a public health problem. Prior to the introduction of DAAs, 150–200,000 people were living with HCV in the UK; 85% of whom are people who inject drugs (PWID). The UK is one of few countries to have established public health surveillance monitoring HCV among PWID through repeat bio-behavioural surveys of PWID, laboratory surveillance of HCV testing and national monitoring of HCV treatment. These real-world data were central to evaluating treatment as prevention (TasP) with statistical models demonstrating reductions in HCV prevalence associated with intensity of treatment scale-up. Evidence shows that Tayside – our pilot intervention site which rapidly scaled-up DAAs through decentralised care pathways in harm reduction and other drug services – has met WHO targets and other UK sites are on track. Linkage of HCV and drugs surveillance data was undertaken in Scotland to create a virtual cohort of people known to be opioid dependent, tracking HCV test/treatment status enabling estimation of (re-)infection rates but also utilised to estimate prevalence of opioid dependence and examine drug-related harms.