Περίληψη:
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.
Συγγραφείς:
Wiessing, Lucas
Ferri, Marica
Grady, Bart
Kantzanou, Maria
and Sperle, Ida
Cullen, Katelyn J.
Hatzakis, Angelos
Prins,
Maria
Vickerman, Peter
Lazarus, Jeffrey V.
Hope, Vivian D.
and Mathei, Catharina
Busch, Martin
Bollaerts, Kaat and
Bogdanova, Violeta
Nesheva, Elmira
Fotsiou, Nasia
Kostrikis,
Leontios
Mravcik, Viktor
Rehak, Vratislav
Castkova, Jitka
and Hobstova, Jirlina
Nechanska, Blanka
Fouchard, Jan and
Abel-Ollo, Katri
Tefanova, Valentina
Tallo, Tatjana and
Brummer-Korvenkontio, Henrikki
Brisacier, Anne-Claire
Michot,
Isabelle
Jauffret-Roustide, Marie
Zimmermann, Ruth
Fotiou,
Anastasios
Gazdag, Gabor
Tarjan, Anna
Galvin, Brian and
Garavan, Carrie
Thornton, Lelia
Cruciani, Mario
Basso,
Monica
Karnite, Anda
Caplinskiene, Irma
Lopes, Sofia and
Origer, Alain
Melillo, Jackie
Camilleri, Moses
Demanuele,
Carlo Olivari
Croes, Esther
Op de Coul, Eline
Rosinska,
Magdalena
Struzik, Marta
Martins, Mario
Duran, Domingos and
Vilar, Graca
Resende, Emilia
Martins, Helena Cortes
Abagiu,
Adrian Octavian
Ruta, Simona
Arama, Victoria
Kopilovic,
Boris
Kustec, Tanja
Klavs, Irena
Aleixandre, Noelia Llorens
and Folch, Cinta
Bravo, Maria Jose
Gomez, Rosario Sendino and
Berglund, Torsten
Strandberg, Joakim
Hope, Vivian
Hotho,
Daphne
Van Houdt, Sabine
Low, Andrea
Mcdonald, Bethan and
Platt, Lucy
Isabelle Giraudon, Eleni Kalamara
Groshkova, Teodora
and Palladino, Claudia
Hutchinson, Sharon
Ncube, Fortune and
Eramova, Irina
Goldberg, David
Vicente, Julian
Griffiths,
Paul
EMCDDA DRID Grp
