Peter Vickerman

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HIV can spread rapidly between people who inject drugs (through injections and sexual transmission), and potentially the virus can pass to the wider community (by sexual transmission). Here, we summarise evidence on the effectiveness of individual-level approaches to prevention of HIV infection; review global and regional coverage of opioid substitution(More)
UNLABELLED Injecting drug use is the main risk of hepatitis C virus (HCV) transmission in most developed countries. HCV antiviral treatment (peginterferon-α + ribavirin) has been shown to be cost-effective for patients with no reinfection risk. We examined the cost-effectiveness of providing antiviral treatment for injecting drug users (IDUs) as compared(More)
BACKGROUND & AIMS Hepatitis C virus antiviral treatment is effective for individual patients but few active injecting drug users are treated. We considered the utility of antiviral treatment for primary prevention of hepatitis C. METHODS A hepatitis C transmission model among injecting drug users was developed, incorporating treatment (62.5% average(More)
BACKGROUND Interventions such as opiate substitution therapy (OST) and high-coverage needle and syringe programs (HCNSP) cannot substantially reduce hepatitis C virus (HCV) prevalence among people who inject drugs (PWID). HCV antiviral treatment may prevent onward transmission. We project the impact of combining OST, HCNSP, and antiviral treatment on HCV(More)
OBJECTIVE To investigate the effect of opiate substitution treatment at the beginning and end of treatment and according to duration of treatment. DESIGN Prospective cohort study. Setting UK General Practice Research Database. PARTICIPANTS Primary care patients with a diagnosis of substance misuse prescribed methadone or buprenorphine during 1990-2005.(More)
BACKGROUND New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand ART eligibility accordingly. METHODS We used multiple independent mathematical models in four settings-South Africa, Zambia,(More)
OBJECTIVES The objectives of this study were to estimate the cost-effectiveness of a harm reduction intervention among injecting drug users (IDUs) in Odessa, Ukraine; and to explore how the cost-effectiveness changes if the intervention were scaled up to 60% as recommended by WHO/UNAIDS. STUDY DESIGN Economic providers' costs were estimated. A dynamic(More)
BACKGROUND People who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. The availability in the literature of information on seven main topic areas (incidence, chronicity, genotypes, HIV co-infection, diagnosis and treatment uptake,(More)
OBJECTIVE To quantify the effect of opiate substitution treatment in relation to HIV transmission among people who inject drugs. DESIGN Systematic review and meta-analysis of prospective published and unpublished observational studies. DATA SOURCES Search of Medline, Embase, PsychINFO, and the Cochrane Library from the earliest year to 2011 without(More)
BACKGROUND Herpes simplex virus type 2 (HSV-2) infection causes significant disease globally. Adolescent and adult infection may present as painful genital ulcers. Neonatal infection has high morbidity and mortality. Additionally, HSV-2 likely contributes substantially to the spread of HIV infection. The global burden of HSV-2 infection was last estimated(More)