5 research outputs found
Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention
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, and burden of disease) to guide HCV treatment and prevention scale-up for PWID in the 27 countries of the European Union is systematically reviewed.
Methods and Findings: We searched MEDLINE, EMBASE and Cochrane Library for publications between 1 January 2000 and 31 December 2012, with a search strategy of general keywords regarding viral hepatitis, substance abuse and geographic scope, as well as topic-specific keywords. Additional articles were found through structured email consultations with a large European expert network. Data availability was highly variable and important limitations existed in comparability and representativeness. Nine of 27 countries had data on HCV incidence among PWID, which was often high (2.7-66/100 person-years, median 13, Interquartile range (IQR) 8.7–28). Most common HCV genotypes were G1 and G3; however, G4 may be increasing, while the proportion of traditionally ‘difficult to treat’ genotypes (G1+G4) showed large variation (median 53, IQR 43–62). Twelve countries reported on HCV chronicity (median 72, IQR 64–81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%, IQR 0.2–28). Undiagnosed infection, assessed in five countries, was high (median 49%, IQR 38–64), while of those diagnosed, the proportion entering treatment was low (median 9.5%, IQR 3.5–15). Burden of disease, where assessed, was high and will rise in the next decade.
Conclusion: Key data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID
Estimating injection drug use prevalence using state wide administrative data sources: Estonia, 2004
Estonia has rapidly expanding injection drug use (IDU) driven HIV/AIDS epidemic with the highest reported incidence rate and prevalence (1.3%) of HIV in the European region. To evaluate the feasibility of IDU prevalence estimations based on routine nationwide data sources using capture-recapture methodology, and provide estimates of IDU prevalence. IDUs were identified from the Police, Health insurance fund, State HIV reference laboratory data sources. Poisson regression models were fitted to the observed data, with interactions between data sources fitted to replicate ‘dependencies’ between the data sources. There were 13,886 (95% CI 8132–34,443) IDUs in Estonia in 2004, which translates into a prevalence of 2.4% (95% CI 1.4–5.9%) among people aged 15–44 years. The estimate is in line with the estimate provided by the panel of experts and estimates from the neighbouring countries experiencing similar societal and economic challenges
International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009
Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention
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, and burden of disease) to guide HCV treatment and
prevention scale-up for PWID in the 27 countries of the European Union
is systematically reviewed.
Methods and Findings: We searched MEDLINE, EMBASE and Cochrane Library
for publications between 1 January 2000 and 31 December 2012, with a
search strategy of general keywords regarding viral hepatitis, substance
abuse and geographic scope, as well as topic-specific keywords.
Additional articles were found through structured email consultations
with a large European expert network. Data availability was highly
variable and important limitations existed in comparability and
representativeness. Nine of 27 countries had data on HCV incidence among
PWID, which was often high (2.7-66/100 person-years, median 13,
Interquartile range (IQR) 8.7-28). Most common HCV genotypes were G1 and
G3; however, G4 may be increasing, while the proportion of traditionally
‘difficult to treat’ genotypes (G1+G4) showed large variation (median
53,IQR 43-62). Twelve countries reported on HCV chronicity (median 72,
IQR 64-81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%,
IQR 0.2-28). Undiagnosed infection, assessed in five countries, was high
(median 49%, IQR 38-64), while of those diagnosed, the proportion
entering treatment was low (median 9.5%, IQR 3.5-15). Burden of
disease, where assessed, was high and will rise in the next decade.
Conclusion: Key data on HCV epidemiology, care and disease burden among
PWID in Europe are sparse but suggest many undiagnosed infections and
poor treatment uptake. Stronger efforts are needed to improve data
availability to guide an increase in HCV treatment among PWID