越南海防市在注射吸毒者中消除丙型肝炎病毒干预措施的影响和成本效益

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-06-21 DOI:10.1016/j.drugpo.2025.104898

Adam Trickey , Josephine G. Walker , Pham Minh Khue , Tran Thi Hong , Nguyen Thanh Binh , Catherine Quillet , Roselyne Vallo , Sandra Bivegete , Khuat Thi Hai Oanh , Hannah Fraser , Duong Thi Huong , Todd Pollack , Vo Thi Tuyet Nhung , Don Des Jarlais , Vu Hai Vinh , Nicolas Nagot , Didier Laureillard , Jack Stone , Peter Vickerman

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引用次数: 0

摘要

在越南海防，大多数丙型肝炎病毒（HCV）感染发生在注射吸毒者（PWID）。作为海防市PWID多次受访者驱动抽样（RDS）调查的一部分，一项干预措施（DRIVE-C）于2019年提供了HCV检测和治疗。提供阿片激动剂治疗（OAT）或抗逆转录病毒治疗（ART）的中心也在2021/22年度提供了HCV检测和与治疗的联系。我们模拟了海防市丙型肝炎病毒检测和治疗PWID的影响和成本效益。方法利用海防市的数据，在贝叶斯框架下对PWID和前注射人员之间的HCV传播模型进行校正。现状（SQ）情景模拟了过去的干预措施，没有未来的HCV治疗。未来的干预方案模拟了在OAT和ART中心提供HCV检测和与治疗联系的影响，以及2025-2030年期间的年度RDS调查干预措施，每次检测1400名PWID。与2025-2054年SQ相比，我们估计了未来情景中每个残疾调整生命年（DALY）的增量成本效益比（ICER）（3%的年贴现率）。结果在SQ情景下，HCV发病率从2015年的8.1 /100人年（95%可信区间5.1-13.6）下降到2023年的5.3/100人年（3.0-9.6），到2030年增加到6.2/100人年（3.5-10.7）。在未来的干预情景中，到2030年发病率将降至2.7/100年（1.0-6.4）。平均成本为€884/DALY避免；在2334欧元（越南2023年人均GDP的57%）的支付意愿门槛下具有成本效益。结论利用RDS调查和其他护理机构扩大HCV检测和治疗是降低越南PWID患者HCV发病率的具有成本效益的策略。

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Impact and cost-effectiveness of interventions to eliminate hepatitis C virus among people who inject drugs in Haiphong, Vietnam

Background

In Haiphong, Vietnam, most hepatitis C virus (HCV) infections occur among people who inject drugs (PWID). As part of multiple respondent-driven sampling (RDS) surveys among PWID in Haiphong, an intervention (DRIVE-C) provided HCV testing and treatment in 2019. Centres providing opiate agonist treatment (OAT) or antiretroviral therapy (ART) also provided HCV testing and linkage-to-treatment in 2021/22. We modelled the impact and cost-effectiveness of HCV testing and treatment for PWID in Haiphong.

Methods

An HCV transmission model among PWID and former injectors was calibrated in a Bayesian framework using data from Haiphong. A status quo (SQ) scenario modelled past interventions, with no future HCV treatment. A future intervention scenario modelled the impact of providing HCV testing and linkage-to-treatment in OAT and ART centres, and annual RDS survey interventions over 2025–2030, each testing 1400 PWID. We estimated the incremental cost-effectiveness ratio (ICER) per disability adjusted life-year (DALY) averted for the future scenario compared to SQ over 2025–2054 (3 % annual discount rate).

Results

For the SQ scenario, HCV incidence decreased from 8.1 (95 % credibility interval 5.1–13.6) per 100 person-years (/100pyrs) in 2015 to 5.3/100pyrs (3.0–9.6) in 2023 and increases to 6.2/100pyrs (3.5–10.7) in 2030. In the future intervention scenario, incidence decreases to 2.7/100pyrs (1.0–6.4) by 2030. The mean ICER is €884/DALY averted; cost-effective at a willingness-to-pay threshold of €2334 (57 % of Vietnam’s 2023 GDP per capita).

Conclusions

Using RDS surveys and other care settings to scale-up HCV-testing and treatment are cost-effective strategies to reduce HCV incidence among PWID in Vietnam.

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.