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We determined the testing frequencies (2\u2010yearly, annually, 6\u2010monthly and 3\u2010monthly) and retention in care required among <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> to achieve the <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> incidence reduction target through treatment as prevention in low (25%), medium (50%) and high (75%) chronic <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> prevalence settings. Mathematical modelling of <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> transmission among <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content>, capturing testing, treatment and other features of the care cascade were employed. In low\u2010prevalence settings, 2\u2010yearly antibody testing of <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> was estimated to reach the elimination target by 2027\u20102030 depending on retention in care, with annual testing reducing the time by up to 3\u00a0years. In medium\u2010prevalence settings, if close to 90% testing coverage were achieved, then annual antibody testing of <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> would be sufficient. If testing coverage were lower (80%), 6\u2010monthly antibody testing with at least 70% retention in care or annual <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">cA<\/jats:styled-content>g testing would be required. In high\u2010prevalence settings, even 3\u2010monthly <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">cA<\/jats:styled-content>g testing of <jats:styled-content style=\"fixed-case\">PWID<\/jats:styled-content> was unable to achieve the incidence reduction target. Thus, for geographical areas or subpopulations with high prevalence, <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> incidence targets are unlikely to be met without 3\u2010monthly RNA\/cAg testing accompanied by other prevention measures. Novel testing strategies, such as rapid point\u2010of\u2010care antibody testing or replacing antibody testing with RNA\/cAg tests as a screening tool, can provide additional population\u2010level impacts to compensate for imperfect follow\u2010up or testing coverage.<\/jats:p>","DOI":"10.1111\/jvh.12975","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T09:45:05Z","timestamp":1532598305000},"page":"1472-1480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Eliminating hepatitis C: The importance of frequent testing of people who inject drugs in high\u2010prevalence settings"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-0798","authenticated-orcid":false,"given":"Nick","family":"Scott","sequence":"first","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Sacks\u2010Davis","sequence":"additional","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Pedrana","sequence":"additional","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Doyle","sequence":"additional","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Victoria Australia"},{"name":"Department of Infectious Diseases The Alfred and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St Vincent's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-3266","authenticated-orcid":false,"given":"Margaret","family":"Hellard","sequence":"additional","affiliation":[{"name":"Disease Elimination Program Burnet Institute  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Clayton Victoria Australia"},{"name":"Department of Infectious Diseases The Alfred and Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-311504"},{"key":"e_1_2_9_3_1","unstructured":"Polaris Observatory.2017http:\/\/polarisobservatory.org\/. 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