{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:24:00Z","timestamp":1792682640468,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009250","name":"National Institute for Social Care and Health Research","doi-asserted-by":"publisher","award":["RP\u2010PG\u20100616\u201020008"],"award-info":[{"award-number":["RP\u2010PG\u20100616\u201020008"]}],"id":[{"id":"10.13039\/100009250","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>There has been little empirical evidence to show the \u2018real\u2010world\u2019 impact of scaling\u2010up direct\u2010acting anti\u2010viral (DAA) treatment among people who inject drugs (PWID) on hepatitis C virus (HCV) viraemia at a population level. We aimed to assess the population impact of rapid DAA scale\u2010up to PWID delivered through community services\u2014including drug treatment, pharmacies, needle exchanges and prisons\u2014in the Tayside region of Scotland, compared with Greater Glasgow and Clyde (GGC) and the Rest of Scotland (RoS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>Natural experiment, evaluated using data from national biennial surveys of PWID and national clinical data. Services providing injecting equipment (2010\u201318) and HCV treatment clinics (2017\u201318) across Scotland. A total of 12\u2009492 PWID who completed a questionnaire and provided a blood spot (tested for HCV\u2010antibodies and RNA); 4105 individuals who initiated HCV treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention and comparator, measurements<\/jats:title>\n                    <jats:p>The intervention was rapid DAA scale\u2010up among PWID, which occurred in Tayside. The comparator was GGC\/RoS. Trends in HCV viraemia and uptake of HCV therapy over time; sustained viral response (SVR) rates to therapy by region and treatment setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Uptake of HCV therapy (last year) among PWID between 2013\u201314 and 2017\u201318 increased from 15 to 43% in Tayside, 6 to 16% in GGC and 11 to 23% in RoS. Between 2010 and 2017\u201318, the prevalence of HCV viraemia (among antibody\u2010positives) declined from 73 to 44% in Tayside, 67 to 58% in GGC and 64 to 55% in RoS. The decline in viraemia was greater in Tayside [2017\u201318 adjusted odds ratio (aOR)\u00a0=\u00a00.47, 95% confidence interval (CI)\u00a0=\u00a00.30\u20130.75,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001] than elsewhere in Scotland (2017\u201318 aOR\u00a0=\u00a00.89, 95% CI\u00a0=\u00a00.74\u20131.07,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.220) relative to the baseline of 2013\u201314 in RoS (including GGC). Per\u2010protocol SVR rates among PWID treated in community sites did not differ from those treated in hospital sites in Tayside (97.4 versus 100.0%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.099).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Scale\u2010up of direct\u2010acting anti\u2010viral treatment among people who inject drugs can be achieved through hepatitis C virus (HCV) testing and treatment in community drug services while maintaining high sustained viral response rates and, in the Tayside region of Scotland, has led to a substantial reduction in chronic HCV in the population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15459","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T09:59:36Z","timestamp":1614679176000},"page":"2893-2907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Reduction in the population prevalence of hepatitis C virus viraemia among people who inject drugs associated with scale\u2010up of direct\u2010acting anti\u2010viral therapy in community drug services: real\u2010world data"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-0173","authenticated-orcid":false,"given":"Norah E.","family":"Palmateer","sequence":"first","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McAuley","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Dillon","sequence":"additional","affiliation":[{"name":"University of Dundee  Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McDonald","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-3695","authenticated-orcid":false,"given":"Alan","family":"Yeung","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanley","family":"Smith","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Barclay","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hayes","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha J.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"West of Scotland Specialist Virology Centre  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory N.","family":"Gunson","sequence":"additional","affiliation":[{"name":"West of Scotland Specialist Virology Centre  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon J.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University  Cowcaddens Road Glasgow G4 0BA UK"},{"name":"Public Health Scotland  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14393"},{"key":"e_1_2_8_3_1","unstructured":"World Health Organization (WHO).Global Health Sector Strategy on Viral Hepatitis 2016\u20132021: towards ending viral hepatitis. 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