title: Mitigating the burden of hepatitis C virus among people who inject drugs in Belgium.
abstract: In 2010, there were an estimated 10 100 PWID in Belgium and 43% (34%-57%) were HCV infected. Understanding HCV transmission dynamics in high-risk populations and assessing the potential impact of improved HCV treatment strategies requires robust epidemiological data and mathematical modeling.
  
  
  METHODS
  CV transmission was modeled using cohorts to track HCV incidence and prevalence among active PWID in the general PWID population, OST and NSP. Model assumptions were derived from published literature and expert consensus. The relative impact of increasing the number of PWID treated with new oral DAAs was considered.
  
  
  RESULTS
  If the current transmission paradigm continues, there will be 2645 HCV-infected PWID in 2030. Annually treating 30 (1% of 2015 population) or 120 (4% of 2015 population) HCV-infected PWID with oral DAAs will result in 5% and 25% reductions, respectively, in HCV-infected PWID by 2030. Treating 370 PWID annually (12.5% of 2015 population) will result in a > 90% reduction by 2030.
  
  
  CONCLUSIONS
  Treating a small number of PWID can result in substantial reduction in HCV prevalence in this population ; however, high levels of treatment are necessary to reduce the viral pool and thus the risk of secondary infections. This analysis supports implementation of a screening and treatment strategy among PWID when combined with an expansion of harm reduction programs.
authors.forename: C
authors.initials: C
authors.lastname: Matheï
authors.forename: S
authors.initials: S
authors.lastname: Bourgeois
authors.forename: S
authors.initials: S
authors.lastname: Blach
authors.forename: C
authors.initials: C
authors.lastname: Brixko
authors.forename: J P
authors.initials: JP
authors.lastname: Mulkay
authors.forename: H
authors.initials: H
authors.lastname: Razavi
authors.forename: G
authors.initials: G
authors.lastname: Robaeys
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001530:Belgium / Q000453:epidemiology; D055030:Drug Users / Q000706:statistics & numerical data*; D040261:Harm Reduction; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D015994:Incidence; D008962:Models, Theoretical; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
chemical_list: D000998:Antiviral Agents