@article{TEXTUAL,
      recid = {6311},
      author = {Tatara, Eric and Gutfraind, Alexander and Collier,  Nicholson T. and Echevarria, Desarae and Cotler, Scott J.  and Major, Marian E. and Ozik, Jonathan and Dahari, Harel  and Boodram, Basmattee},
      title = {Modeling hepatitis C micro-elimination among people who  inject drugs with direct-acting antivirals in metropolitan  Chicago},
      journal = {PLOS ONE},
      address = {2022-03-10},
      number = {TEXTUAL},
      abstract = {Hepatitis C virus (HCV) infection is a leading cause of  chronic liver disease and mortality worldwide.  Direct-acting antiviral (DAA) therapy leads to high cure  rates. However, persons who inject drugs (PWID) are at risk  for reinfection after cure and may require multiple DAA  treatments to reach the World Health Organization’s (WHO)  goal of HCV elimination by 2030. Using an agent-based model  (ABM) that accounts for the complex interplay of  demographic factors, risk behaviors, social networks, and  geographic location for HCV transmission among PWID, we  examined the combination(s) of DAA enrollment (2.5%, 5%,  7.5%, 10%), adherence (60%, 70%, 80%, 90%) and frequency of  DAA treatment courses needed to achieve the WHO’s goal of  reducing incident chronic infections by 90% by 2030 among a  large population of PWID from Chicago, IL and surrounding  suburbs. We also estimated the economic DAA costs  associated with each scenario. Our results indicate that a  DAA treatment rate of >7.5% per year with 90% adherence  results in 75% of enrolled PWID requiring only a single DAA  course; however 19% would require 2 courses, 5%, 3 courses  and <2%, 4 courses, with an overall DAA cost of $325  million to achieve the WHO goal in metropolitan Chicago. We  estimate a 28% increase in the overall DAA cost under low  adherence (70%) compared to high adherence (90%). Our  modeling results have important public health implications  for HCV elimination among U.S. PWID. Using a range of  feasible treatment enrollment and adherence rates, we  report robust findings supporting the need to address  re-exposure and reinfection among PWID to reduce HCV  incidence.},
      url = {http://knowledge.uchicago.edu/record/6311},
}