Table B.3 is separated into 5 smaller tables in this HTML version for accessibility reasons. It is presented as one table in the PDF version.

Transmission
Disease progression without treatment
Commencement of treatment
Stopping treatment
Clearance of virus
References

Transmission

Symbol Description Values References
HCV Transmission probability of hepatitis C per injection with a contaminated syringe
1.5-4%

Disease progression without treatment

Symbol Description Values References
1/τA Average time for untreated HCV infected individuals to progress from acute infection to the first stage of fibrosis (F0)
4-8 months
[178, 179]
1/τF0-F1Average time from fibrosis stage F0 to F1 - HCV monoinfection
[Annual transition probability]
8.62 (0.23-16.95) years
[0.116 (0.059-0.228)]
[180, 181]
1/τF0-F1Average time from fibrosis stage F0 to F1 - HCV coinfection with HIV
[Annual transition probability]
8.20 (6.54-10.20) years
[0.122 (0.098-0.153)]
[180, 181]
1/τF1-F2Average time from fibrosis stage F1 to F2 - HCV monoinfection
[Annual transition probability]
11.76 (9.09-15.38) years
[0.085 (0.065-0.110)]
[180, 181]
1/τF1-F2Average time from fibrosis stage F1 to F2 - HCV coinfection with HIV
[Annual transition probability]
8.70 (7.14-10.53) years
0.115 (0.095-0.140)]
[180, 181]
1/τF2-F3Average time from fibrosis stage F2 to F3 - HCV monoinfection
[Annual transition probability]
11.76 (6.80-20.41) years
[0.085 (0.049-0.147)]
[180, 181]
1/τF2-F3Average time from fibrosis stage F2 to F3 - HCV coinfection with HIV
[Annual transition probability]
8.06 (6.29-10.31) years
[0.124 (0.097-0.159)]
[180, 181]
1/τF3-F4Average time from fibrosis stage F3 to F4 - HCV monoinfection
[Annual transition probability]
7.69 (3.13-18.87) years
[0.130 (0.053-0.319)]
[180, 181]
1/τF3-F4Average time from fibrosis stage F3 to F4 - HCV coinfection with HIV
[Annual transition probability]
8.70 (7.41-10.20) years
[0.115 (0.098-0.135)]
[180, 181]
1/τF4-LFAverage time from F4 to liver failure
[Annual transition probability]
18.18 (10.87-25.0) years
[0.055 (0.040-0.092)]
1/τF4-HCCAverage time from F4 to hepatocellular carcinoma
[Annual transition probability]
32.26 (26.32-41.67) years
[0.031 (0.024-0.038)]
1/τLF-HCCAverage time from liver failure to hepatocellular carcinoma
[Annual transition probability]
14.71 (10.10-24.39) years
[0.068 (0.041-0.099)]
[198, 199]
1/τLF-LTAverage time from liver failure until liver transplant
Annual transition probability]
30.30 (20.41-58.82) years
[0.033 (0.017-0.049)]
[200]
1/τHCC-LTAverage time until liver transplant for individuals with hepatocellular carcinoma
[Annual transition probability]
10.0 (5.56-20.0) years
[0.1 (0.05-0.18)]
[201], c
1/LF-LD Average time until liver-related death for individuals with liver failure
[Annual transition probability]
7.25 (4.95-13.51) years
[0.138 (0.074–0.202)]
[187]
1/LT-LD Average time until liver-related death for individuals who have received a liver transplant - First year [Annual transition probability]
5.92 (4.76-7.87) years
[0.169 (0.127-0.210)]
[202, 203], d
1/LT-LD Average time until liver-related death for individuals who have received a liver transplant - After first year [Annual transition probability]
29.41 (23.26-41.67) years
[0.034 (0.024-0.043)]
[202, 203], d
1/HCC-LD Average time until liver-related death for individuals with hepatocellular carcinoma [Annual transition probability]
1.65 (1.48-1.83) years
[0.605 (0.545-0.676)]
[191]
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Commencement of treatment

SymbolDescriptionValuesReferences
Proportion treated for acute/early HCV infection - HCV monoinfection
0.002-0.003
[23, 201]
Proportion treated for acute/early HCV infection - HCV coinfection with HIV
0.07-0.13
[23, 201]
1/ηAAverage time before individuals in acute/early HCV infection commence treatment - HCV monoinfection - Asymptomatic
320 (213-399) days
1/ηAAverage time before individuals in acute/early HCV infection commence treatment - HCV monoinfection - Symptomatic
221 (188-274) days
1/ηAAverage time before individuals in acute/early HCV infection commence treatment - HCV coinfection with HIV - Asymptomatic
234 (161-392) days
1/ηAAverage time before individuals in acute/early HCV infection commence treatment - HCV coinfection with HIV - Symptomatic
181 (146-223) days
ηFProportion of individuals of fibrosis HCV infection to commence treatment per year - F0/1
25-30%
[204]
ηFProportion of individuals of fibrosis HCV infection to commence treatment per year - F2/3
46-60%
[204]
ηFProportion of individuals of fibrosis HCV infection to commence treatment per year - F4
15-25%
[204]

Stopping treatment

SymbolDescriptionValuesReferences
1/vAverage duration of treatment - Acute - HCV monoinfection
0.46 years
[205]
1/vAverage duration of treatment - Acute - HCV coinfection with HIV
0.46 years
[205]
1/vAverage duration of treatment - F0-F4 - HCV monoinfection
0.69 years
[206, 207]
1/vAverage duration of treatment - F0-F4 - HCV coinfection with HIV
0.92 years
[208]

Clearance of virus

SymbolDescriptionValuesReferences
ψProportion of IDUs who spontaneously clear HCV - Acute - HCV monoinfection
0.26 (0.22-0.29)
[209]
ψProportion of IDUs who spontaneously clear HCV - Acute - Relative clearance rate due to coinfection compared with monoinfection
0.16-0.88
γAProportion of HCV-treated individuals who clear the virus due to treatment (sustained virological responders) in acute HCV - HCV monoinfection
0.6-0.9
γAProportion of HCV-treated individuals who clear the virus due to treatment (sustained virological responders) in acute HCV - HCV coinfection with HIV
Same as monoinfection
[218, 219]
γF0Proportion of HCV-treated individuals who clear the virus due to treatment in F0 phase - HCV monoinfection
0.60 (0.52-0.68)
[207, 220, 221]
γF0Proportion of HCV-treated individuals who clear the virus due to treatment in F0 phase - HCV coinfection with HIV
0.38 (0.29-0.48)
γFProportion of HCV-treated individuals who clear the virus due to treatment in F1-F4 phase - HCV monoinfection
0.56 (0.50-0.61)
γFProportion of HCV-treated individuals who clear the virus due to treatment in F1-F4 phase - HCV coinfection with HIV
0.38 (0.29-0.48)
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References

Reference a

No study has directly estimated the probability of HCV transmission per injection by IDUs using a contaminated syringe. Numerous studies have estimated the transmission risk of HCV in an occupational setting due to needlestick injury.167, 171-177 In the absence of other data, we use these studies to estimate transmission risk among IDUs sharing syringes. We reviewed these studies, paying particular attention on long-term cohort studies with larger number of cases, leading to a plausible range of transmission risk per exposure of 1.5-4%.

Reference b

Pooled estimate from a survey of the literature;182-198 weighted using sample size.

Reference c

11 of 111 new HCV-related HCC reported cases in 2007 in Australia received a liver transplant201 This leads to a 95% confidence interval of 5-18%.

Reference d

Our deterministic ordinary differential equation model assumes exponential rates. We determined the best-fitting exponential function over 40 years, leading to an average transition probability of 0.043 (0.0294, 0.0557) per year, which is equivalent to an average time of 23.26 (17.95-34.01).

Reference e

Based on unpublished data from the Australian Trial in Acute Hepatitis C (ATAHC) study.
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