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

Image structure preserving of lossy compression in the sense of perceptual distortionwhen using anisotropic diffusion preprocessing

In this paper we show how the image structure can be better preserved at lossy compression, when compression artifact is reduced with perceptually adaptive filtering by means of anisotropic diffusion, performed on the image before coding. Adaptive filtering extracts and preserves the important visual information, and it will be discussed in the context of the non-linear scale-space theory. Among the proposed non-linear diffusion equation we shall identify the one that is adequate for preprocessing. The effect of linear and non-linear diffusions prior to Joint Photographic Experts Group’s (JPEG) standard baseline compression is analyzed and compared. It is shown that the selection of the appropriate preprocessing parameters at a specified bit-rate greatly reduces the compression artifacts. The selection criteria were determined using a perceptual error metric based on a model of the human visual system (HVS). The proposed method preserves well the main structure of the decompressed image and it does not change the perceptible image quality of the decompressed image considering all the details, while removing most of the compression artifacts. Application of the non-linear scale-space theory to non-recoverable, low bit-rate image compression will be presented. In particular, the method discussed is a preprocessing that improves the JPE