@article{3162402,
    title = "Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs
in Europe: A Systematic Review of Data for Scaling Up Treatment and
Prevention",
    author = "Wiessing, Lucas and Ferri, Marica and Grady, Bart and Kantzanou, Maria and and Sperle, Ida and Cullen, Katelyn J. and Hatzakis, Angelos and Prins, and Maria and Vickerman, Peter and Lazarus, Jeffrey V. and Hope, Vivian D. and and Mathei, Catharina and Busch, Martin and Bollaerts, Kaat and and Bogdanova, Violeta and Nesheva, Elmira and Fotsiou, Nasia and Kostrikis, and Leontios and Mravcik, Viktor and Rehak, Vratislav and Castkova, Jitka and and Hobstova, Jirlina and Nechanska, Blanka and Fouchard, Jan and and Abel-Ollo, Katri and Tefanova, Valentina and Tallo, Tatjana and and Brummer-Korvenkontio, Henrikki and Brisacier, Anne-Claire and Michot, and Isabelle and Jauffret-Roustide, Marie and Zimmermann, Ruth and Fotiou, and Anastasios and Gazdag, Gabor and Tarjan, Anna and Galvin, Brian and and Garavan, Carrie and Thornton, Lelia and Cruciani, Mario and Basso, and Monica and Karnite, Anda and Caplinskiene, Irma and Lopes, Sofia and and Origer, Alain and Melillo, Jackie and Camilleri, Moses and Demanuele, and Carlo Olivari and Croes, Esther and Op de Coul, Eline and Rosinska, and Magdalena and Struzik, Marta and Martins, Mario and Duran, Domingos and and Vilar, Graca and Resende, Emilia and Martins, Helena Cortes and Abagiu, and Adrian Octavian and Ruta, Simona and Arama, Victoria and Kopilovic, and Boris and Kustec, Tanja and Klavs, Irena and Aleixandre, Noelia Llorens and and Folch, Cinta and Bravo, Maria Jose and Gomez, Rosario Sendino and and Berglund, Torsten and Strandberg, Joakim and Hope, Vivian and Hotho, and Daphne and Van Houdt, Sabine and Low, Andrea and Mcdonald, Bethan and and Platt, Lucy and Isabelle Giraudon, Eleni Kalamara and Groshkova, Teodora and and Palladino, Claudia and Hutchinson, Sharon and Ncube, Fortune and and Eramova, Irina and Goldberg, David and Vicente, Julian and Griffiths, and Paul and EMCDDA DRID Grp",
    journal = "PLOS ONE",
    year = "2014",
    volume = "9",
    number = "7",
    publisher = "Public Library of Science",
    doi = "10.1371/journal.pone.0103345",
    abstract = "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."
}