Diversity of HCV among hepatitis C-infected PWID in India
Accurate HCV incidence estimates will be critical for monitoring the impact of treatment rollouts and also for continued monitoring of the course of the HCV epidemic among PWIDs and for identifying individuals and networks who are at high risk for acquisition and ongoing transmission of HCV. While HCV incidence is often monitored and evaluated in longitudinal studies these studies are logistically difficult, resource intensive, and the study participants enrolled in such studies are subject to their own biases and may not reflect the underlying population at risk. Currently there is no single assay or combination of assays that have been developed and validated for the detection of recent HCV infection. Building on the experience related to development of a cross-sectional incidence algorithm for HIV, our group has been working to develop and validate a laboratory-based method to accurately detect incident HCV infections in populations of PWIDs in Baltimore, MD and India. Once the method has been validated we will apply the method to a set of samples derived from 12 cross-sectional studies of PWIDs across India to better understand the factors associated with recent HCV infection in this population in. In these 12 sites, we have previously collected data on injection network through RDS recruitment and respondent provided network description. We aim to integrate prevalence and incidence data with network and sequence data to better understand the drivers of the dynamics of transmission of HCV in 12 sites across India with differing stages of HIV and drug use epidemics.