The current scientific aims are:
To assess the effect new rapid HCV testing and counseling (T&C) procedures on injection and sexual risk behaviors, HIV testing uptake, HCV incidence rates, and linkage to HIV and HCV care. The impact of which will be assessed by comparing new data to historical data collected in previous years and prior to the availability of rapid HCV testing, which began in 2012. Likage to HIV care is a key goal for the Treatment as Prevention (TaSP) paradigm, and the impeding availabilty of new highly effecting HCV treatments have potential to impact HCV in PWID.
Second, we will expand our prospective cohort study of HCV injecting partnerships. This partners' cohort is uniquely positioned to provide important knowledge on HCV transmission events that we can corroborate with phylogenic analysis. Our principal study aim is to estimate the effect of the level of HCV viremia of the infected partner on HCV transmission rate.
Third, we will continue our study of factors of immunological, genetic, and hormonal factors that explain sex differences in divergent outcomes of acute HCV infection.
Lastly, we aim to determine the contribution of the viral sequence heterogeneity to CD8 T cell responses during HCV reinfection comparing the sequence homology of reinfecting HCV isolates to those of initial viral isolates.
Results from these studies will provide meaningful translational information, and fill important gaps in information regarding natural history and mechanisms of infection, especially with regard to sex differences in response to HCV infection. The studies will inform HCV prevention, including public health measures, clinical and vaccine science.