The epidemiology of viral hepatitis among people who inject drugs: Results of global systematic reviews
By Paul K. Nelson, Bradley M. Mathers, B. Cowie, H. Hagan, D. D. Jarlais, D. Horyniak, L. Degenhardt. The Lancet, 2011
1,396 citations recorded by the source corpus.
Background Injecting drug use (IDU) is an important risk for viral hepatitis transmission. Detailed, transparent estimates of the scale of the problem at regional and global levels have never been made. We report national, regional and global prevalence and population size estimates for hepatitis C (HCV) and hepatitis B (HBV) among people who inject drugs. Methods Systematic search of peer-reviewed (Medline/Embase/PsycINFO) and grey literature databases, conference abstracts and online resources, with a widely distributed call for additional data. From 4386 peer-reviewed and 1019 grey literature sources, 1125 were reviewed in full. Studies were extracted to a customised database and graded according their methods. Serological reports of HCV antibodies/anti-HCV, HBV antibodies/anti-HBc, and/or HBV surface antigen/HBsAg among IDUs samples with n>40 participants, <100% HIV-positive, and sampling frames that did not exclude participants on the basis of age or sex were included. Using endorsed decision rules, prevalence estimates were calculated with anti-HCV and anti-HBV as proxies for exposure and HBsAg for current infection. These were combined with IDU population sizes to estimate the number of HBV and HCV positive IDUs. Findings Eligible reports of anti-HCV among IDUs were located for 77 countries. Prevalence was 60–80% in 26 countries and >80% in 12. We estimate worldwide about 10.0 million (range 6.0–15.2M) IDUs might be anti-HCV positive. China, (1.6M), the USA (1.5M) and the Russian Federation (1.3M) had by far the largest such populations. HBsAg reports were found for 59 countries, ranging from 5–10% in 21 countries and over 10% in 10. Worldwide, 6.4 million IDU might be anti-HBc positive (2.3–9.7M), and 1.2 million (0.3–2.7M) HBsAg positive. Interpretation The prevalence of anti-HCV among IDUs is far greater than HIV. Viral hepatitis clearly poses a challenge to public health. Variation in the coverage and quality of existing research creates uncertainty around estimates. Better and more complete data and reporting are required to estimate the scale of the problem, to inform efforts to prevent and treat HCV and HBV among IDUs.
Subfields: Epidemiology, Hepatology
View Paper: https://www.semanticscholar.org/paper/070c56dbd81e7d696b6bc67a8b06c88abc274798
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Citations in the corpus
- Global epidemiology and genotype distribution of the hepatitis C virus infection. (2014, background): “2 million) PWIDs worldwide may be anti-HCV positive [26,27].”
- Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (2018, background): “8%) of persons who inject drugs (PWID) in a variety of settings (75) and 22.”
- Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. (2016, background): “Duplicate data (145) HIV/HCV denominator (83) No co-infection (588) Review (59) Population confounding characteristics (333) HIV positive sample <50 (165) Couldn’t find (25) Studies included in quantitative synthesis (n = 783)”
- EASL Recommendations on Treatment of Hepatitis C 2016. (2017, background): “The prevalence of HCV among PWIDs is ~65% [80-82] and >80% among long-term PWIDs [80].”