The following is a summary of “Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis,” published in the June 2023 issue of Gastroenterology & Hepatology by Artenie et al.
Assessing the prevalence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is crucial for monitoring advancements toward eradication. Researcher’s objective was to provide a comprehensive overview of worldwide data on HIV and primary HCV incidence among people who inject drugs (PWID) and their correlations with age and sex or gender. In this systematic review and meta-analysis, investigators conducted a comprehensive search of the MEDLINE, Embase, and PsycINFO databases to gather updated information on the incidence of HIV and HCV among people who inject drugs (PWID). They included studies published between January 1, 2000, and December 12, 2022, without language or study design limitations. They reached out to the authors of the identified studies to request any unpublished or updated data. They also incorporated research that assessed the occurrence rate by conducting repeated tests on individuals at risk of infection or by employing diagnostic tests to detect recent diseases.
The study group combined the occurrence and relative risk (RR; young [typically defined as ≤25 years] vs. older people who inject drugs [PWID]; women vs. men) measurements using random-effects meta-analysis and evaluated the potential for bias using a modified Newcastle–Ottawa scale. This study is registered with PROSPERO, a comprehensive database of systematic reviews in healthcare, under the registration number CRD42020220884. Investigators revised search yielded 9,493 medical publications, of which 211 met the criteria for full-text evaluation. An additional 377 full-text medical records were assessed from their existing database, and five medical records were identified through cross-referencing. Of the 125 records that met the inclusion criteria, 28 were unpublished. They have identified 64 estimates of HIV incidence (30 from high-income countries [HICs] and 34 from low-income or middle-income countries [LMICs]) and 66 estimates of HCV incidence (52 from HICs and 14 from LMICs). About 41 (64%) out of 64 HIV and 42 (64%) out of 66 HCV estimates were derived from single urban areas instead of representing multiple cities or the entire nation.
Estimates were obtained from 1987 to 2021 for HIV and from 1992 to 2021 for HCV. The pooled incidence of HIV was 1·7 per 100 person-years (95% CI 1·3–2·3; i2=98·4%), while the pooled incidence of HCV was 12·1 per 100 person-years (10·0–14·6; i2=97·2%). Young people who inject drugs (PWID) exhibited a higher risk of acquiring HIV (relative risk [RR] 1.5, 95% confidence interval [CI] 1.2-1.8; i2=66.9%) and HCV (1.5, 1.3-1.8; i2=70.6%) compared to older PWID. Females exhibited a higher susceptibility to HIV (RR 1·4, 95% CI 1·1–1·6; i2=55·3%) and HCV (1·2, 1·1–1·3; i2=43·3%) transmission compared to males. For both Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV), the median risk-of-bias score was 6 (interquartile range 6–7), suggesting a moderate level of risk.
Source: sciencedirect.com/science/article/pii/S2468125323000183
