{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:02:28Z","timestamp":1785499348327,"version":"3.56.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T00:00:00Z","timestamp":1629590400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Between 2014 and 2019, the SToP\u2010C trial observed a halving in HCV incidence in four Australian prisons following scale\u2010up of direct\u2010acting antiviral (DAA) therapy. However, the contribution of HCV treatment to this decline is unclear because the study did not have a control group. We used modeling to consider this question.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We parameterized and calibrated a dynamic model of HCV transmission in prisons to data from each SToP\u2010C prison on incarceration dynamics, injecting drug use, HCV prevalence trends among prison entrants, baseline HCV incidence before treatment scale\u2010up, and subsequent HCV treatment scale\u2010up. The model projected the decrease in HCV incidence resulting from increases in HCV treatment and other effects. We assessed whether the model agreed better with observed reductions in HCV incidence overall and by prison if we included HCV treatment scale\u2010up, and its prevention benefits, or did not. The model estimated how much of the observed decrease in HCV incidence was attributable to HCV treatment in prison. The model projected a decrease in HCV incidence of 48.5% (95% uncertainty interval [UI], 41.9\u201054.1) following treatment scale\u2010up across the four prisons, agreeing with the observed HCV incidence decrease (47.6%; 95% CI, 23.4\u201064.2) from the SToP\u2010C trial. Without any in\u2010prison HCV treatment, the model indicated that incidence would have decreased by 7.2% (95% UI, \u22120.3 to 13.6). This suggests that 85.1% (95% UI, 72.6\u2010100.6) of the observed halving in incidence was from HCV treatment scale\u2010up, with the remainder from observed decreases in HCV prevalence among prison entrants (14.9%; 95% UI, \u22120.6 to 27.4).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our results demonstrate the prevention benefits of scaling up HCV treatment in prison settings. Prison\u2010based DAA scale\u2010up should be an important component of HCV elimination strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32002","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T06:53:44Z","timestamp":1623221624000},"page":"2366-2379","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Evaluating the Prevention Benefit of HCV Treatment: Modeling the SToP\u2010C Treatment as Prevention Study in Prisons"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3141-7496","authenticated-orcid":false,"given":"Aaron G.","family":"Lim","sequence":"first","affiliation":[{"name":"Population Health Sciences,Bristol Medical School,University of Bristol,Bristol,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4584-0068","authenticated-orcid":false,"given":"Jack","family":"Stone","sequence":"additional","affiliation":[{"name":"Population Health Sciences,Bristol Medical School,University of Bristol,Bristol,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behzad","family":"Hajarizadeh","sequence":"additional","affiliation":[{"name":"The Kirby Institute,UNSW Sydney,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Byrne","sequence":"additional","affiliation":[{"name":"The Kirby Institute,UNSW Sydney,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina M.","family":"Chambers","sequence":"additional","affiliation":[{"name":"Centre for Big Data Research in Health,University of New South Wales,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha K.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Global Public Health,University of California San Diego,San Diego,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Grebely","sequence":"additional","affiliation":[{"name":"The Kirby Institute,UNSW Sydney,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4741-2622","authenticated-orcid":false,"given":"Gregory J.","family":"Dore","sequence":"additional","affiliation":[{"name":"The Kirby Institute,UNSW Sydney,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Lloyd","sequence":"additional","affiliation":[{"name":"The Kirby Institute,UNSW Sydney,Sydney,NSW,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8291-5890","authenticated-orcid":false,"given":"Peter","family":"Vickerman","sequence":"additional","affiliation":[{"name":"Population Health Sciences,Bristol Medical School,University of Bristol,Bristol,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,22]]},"reference":[{"key":"hep32002-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1002\/hep.26387","article-title":"Incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta\u2010analysis","volume":"58","year":"2013","journal-title":"Hepatology"},{"key":"hep32002-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review","volume":"5","year":"2017","journal-title":"Lancet Glob Health"},{"key":"hep32002-bib-0004-20250824","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/jvh.12701","article-title":"Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005\u20102014: the HITS\u2010p study","volume":"24","year":"2017","journal-title":"J Viral Hepat"},{"key":"hep32002-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.drugpo.2017.12.013","article-title":"Longitudinal injecting risk behaviours among people with a history of injecting drug use in an Australian prison setting: the HITS\u2010p study","volume":"54","year":"2018","journal-title":"Int J Drug Policy"},{"key":"hep32002-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/S2468-1253(18)30304-2","article-title":"Direct\u2010acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta\u2010analysis","volume":"3","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep32002-bib-0008-20250824","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/COH.0000000000000179","article-title":"The hepatitis C virus epidemics in key populations (including people who inject drugs, prisoners and MSM): the use of direct\u2010acting antivirals as treatment for prevention","volume":"10","year":"2015","journal-title":"Curr Opin HIV AIDS"},{"key":"hep32002-bib-0009-20250824","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1093\/cid\/cix1007","article-title":"Declining hepatitis C virus (HCV) incidence in Dutch human immunodeficiency virus\u2010positive men who have sex with men after unrestricted access to HCV therapy","volume":"66","year":"2018","journal-title":"Clin Infect Dis"},{"key":"hep32002-bib-0010-20250824","article-title":"A treatment as prevention trial to eliminate hepatitis C among men who have sex with men living with HIV in the Swiss HIV Cohort Study","year":"2020","journal-title":"Clin Infect Dis"},{"key":"hep32002-bib-0011-20250824","article-title":"Decline in hepatitis C virus (HCV) incidence in men who have sex with men living with human immunodeficiency virus: progress to HCV microelimination in the United Kingdom?","year":"2020","journal-title":"Clin Infect Dis"},{"key":"hep32002-bib-0012-20250824","first-page":"466","article-title":"HIV treatment as prevention among people who inject drugs\u2014a re\u2010evaluation of the evidence","volume":"46","year":"2017","journal-title":"Int J Epidemiol"},{"key":"hep32002-bib-0015-20250824","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S2468-1253(21)00077-7","article-title":"Evaluation of hepatitis C treatment\u2010as\u2010prevention within Australian prisons (SToP\u2010C): a prospective cohort study","volume":"6","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep32002-bib-0018-20250824","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/jvh.12852","article-title":"Uptake of direct\u2010acting antiviral treatment for chronic hepatitis C in Australia","volume":"25","year":"2018","journal-title":"J Viral Hepat"},{"key":"hep32002-bib-0019-20250824","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.drugpo.2019.02.013","article-title":"Outcomes of a nurse\u2010led model of care for hepatitis C assessment and treatment with direct\u2010acting antivirals in the custodial setting","volume":"72","year":"2019","journal-title":"Int J Drug Policy"},{"key":"hep32002-bib-0020-20250824","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1365-2893.2005.00651.x","article-title":"Spontaneous viral clearance following acute hepatitis C infection: a systematic review of longitudinal studies","volume":"13","year":"2006","journal-title":"J Viral Hepat"},{"key":"hep32002-bib-0021-20250824","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/add.14012","article-title":"Needle and syringe programmes and opioid substitution therapy for preventing HCV transmission among people who inject drugs: findings from a Cochrane review and meta\u2010analysis","volume":"113","year":"2018","journal-title":"Addiction"},{"key":"hep32002-bib-0022-20250824","doi-asserted-by":"crossref","first-page":"e1208","DOI":"10.1016\/S2214-109X(17)30373-X","article-title":"Global, regional, and country\u2010level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: a systematic review","volume":"5","year":"2017","journal-title":"Lancet Global Health"},{"key":"hep32002-bib-0023-20250824","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/add.14830","article-title":"Combined treatment and prevention strategies for hepatitis C virus elimination in the prisons in New South Wales: a modelling study","volume":"115","year":"2020","journal-title":"Addiction"},{"key":"hep32002-bib-0024-20250824","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1002\/hep.28497","article-title":"Is increased hepatitis C virus case\u2010finding combined with current or 8\u2010week to 12\u2010week direct\u2010acting antiviral therapy cost\u2010effective in UK prisons? A prevention benefit analysis","volume":"63","year":"2016","journal-title":"Hepatology"},{"key":"hep32002-bib-0025-20250824","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1111\/add.13783","article-title":"Modelling the impact of incarceration and prison\u2010based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland","volume":"112","year":"2017","journal-title":"Addiction"},{"key":"hep32002-bib-0026-20250824","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.jtbi.2018.11.013","article-title":"Mathematical modeling of hepatitis c virus (HCV) prevention among people who inject drugs: a review of the literature and insights for elimination strategies","volume":"481","year":"2019","journal-title":"J Theor Biol"},{"key":"hep32002-bib-0027-20250824","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1111\/jvh.13187","article-title":"Modelling the potential prevention benefits of a treat\u2010all hepatitis C treatment strategy at global, regional, and country levels: a modelling study","volume":"26","year":"2019","journal-title":"J Viral Hepat"},{"key":"hep32002-bib-0028-20250824","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1097\/00002030-200011100-00022","article-title":"Complementary hypothesis concerning the community sexually transmitted disease mass treatment puzzle in Rakai, Uganda","volume":"14","year":"2000","journal-title":"AIDS"},{"key":"hep32002-bib-0029-20250824","article-title":"HIV treatment as prevention: considerations in the design, conduct, and analysis of cluster randomized controlled trials of combination HIV prevention","volume":"9","year":"2012","journal-title":"PLoS Med"},{"key":"hep32002-bib-0030-20250824","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1111\/add.14267","article-title":"Modelling the impact of a national scale\u2010up of interventions on hepatitis C virus transmission among people who inject drugs in Scotland","volume":"113","year":"2018","journal-title":"Addiction"},{"key":"hep32002-bib-0031-20250824","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.1016\/S2214-109X(13)70083-4","article-title":"Assessment of the population\u2010level effectiveness of the Avahan HIV\u2010prevention programme in South India: a preplanned, causal\u2010pathway\u2010based modelling analysis","volume":"1","year":"2013","journal-title":"Lancet Global Health"},{"key":"hep32002-bib-0033-20250824","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S2468-1253(19)30085-8","article-title":"The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: a modelling study","volume":"4","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep32002-bib-0034-20250824","first-page":"502","article-title":"\u2018Fighting a losing battle\u2019: prisoners\u2019 perspectives of treatment as prevention for hepatitis C with inadequate primary prevention measures","volume":"26","year":"2018","journal-title":"Drugs Educ Prev Policy"},{"key":"hep32002-bib-0035-20250824","first-page":"130","article-title":"Behind closed doors, no one sees, no one knows\u2019: hepatitis C, stigma and treatment\u2010as\u2010prevention in prison","volume":"30","year":"2018","journal-title":"Critical Public Health"},{"key":"hep32002-bib-0036-20250824","doi-asserted-by":"crossref","first-page":"102693","DOI":"10.1016\/j.drugpo.2020.102693","article-title":"Perceptions and concerns of hepatitis C reinfection following prison\u2010wide treatment scale\u2010up: counterpublic health amid hepatitis C treatment as prevention efforts in the prison setting","volume":"77","year":"2020","journal-title":"Int J Drug Policy"},{"key":"hep32002-bib-0037-20250824","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1111\/j.1360-0443.2012.03932.x","article-title":"Can needle and syringe programmes and opiate substitution therapy achieve substantial reductions in hepatitis C virus prevalence? Model projections for different epidemic settings","volume":"107","year":"2012","journal-title":"Addiction"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep.32002","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep.32002","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.32002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T23:09:08Z","timestamp":1756076948000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.32002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,22]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.32002","relation":{},"ISSN":["0270-9139","1527-3350"],"issn-type":[{"value":"0270-9139","type":"print"},{"value":"1527-3350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,22]]},"assertion":[{"value":"2021-02-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}