EPIToPe - workstreams

Does scaling up Hepatitis C Virus (HCV) treatment among People Who Inject Drugs (PWID) reduce HCV prevalence and transmission in the population? We aim to generate robust UK empirical evidence on a 'Treatment as Prevention' (TasP) hypothesis for HCV.

Workstream 1: Scaling-up HCV treatment

We demonstrate that a rapid large-scale Hepatitis C Virus (HCV) treatment study in people who inject drugs (PWID) across a range of services in the community can be delivered.  We assess cure and reinfection rates for Workstreams 3, 4 and 5.

Workstream 2: HCV Treatment as Prevention outcomes through enhancing routine surveillance and record linkage

We determine the trends in chronic HCV among PWID prior to and during intervention in control and intervention sites for use in Workstream 4.  We link administrative databases to assess whether successful HCV treatment improves addiction outcomes for comparison with Workstream 3; and improve estimates of PWID prevalence for Workstream 4.

Workstream 3: Understanding the barriers and facilitators to scaling-up community-based HCV treatment

We use qualitative methods (co-produced by peer researchers) to understand the barriers and facilitators to scaling-up community-based HCV treatment, and to produce a manual for scaling-up HCV treatment for Workstream 5. We investigate from patients’ perspective if HCV treatment changes addiction recovery trajectory.

Workstream 4: Modelling impact and cost-effectiveness

We adapt synthetic control methods to estimate the intervention effect for Workstream 1.  We determine cost-effectiveness, compare model projections with observed data, and estimate contribution of other primary interventions to the intervention effect.

Workstream 5: TasP trial in England

We co-design with HCV network leads an evaluation of HCV Treatment as Prevention in England to provide definitive evidence for patients, clinicians and policy-makers.

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