Background
Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) coinfection is a major
global health problem especially among people who inject drugs (PWID), with significant
clinical implications. Mathematical models have been used to great effect to shape HIV
care, but few have been proposed for HIV/HCV.
Methods
We constructed a deterministic compartmental ODE model that incorporated layers for HIV
disease progression, HCV disease progression and PWID demography. Antiretroviral therapy
(ART) and Methadone Maintenance Therapy (MMT) scale-ups were modeled as from
2016 and projected forward 10 years. HCV treatment roll-out was modeled beginning in
2026, after a variety of MMT scale-up scenarios, and projected forward 10 years.
Results
Our results indicate that scale-up of ART has a major impact on HIV though not on HCV burden.
MMT scale-up has an impact on incidence of both infections. HCV treatment roll-out
has a measurable impact on reductions of deaths, increasing multifold the mortality reductions
afforded by just ART/MMT scale-ups. Conclusion
HCV treatment roll-out can have major and long-lasting effects on averting PWID deaths on
top of those averted by ART/MMT scale-up. Efficient intervention scale-up of HCV alongside
HIV interventions is critical in Vietnam.