Global, regional, and country-level coverage of testing and treatment for HIV and hepatitis C infection among people who inject drugs: a systematic review

People who inject drugs are disproportionately affected by HIV and hepatitis C virus (HCV) infections, while there is little global data on HIV and HCV testing and treatment coverage of this population. We conducted a systematic review to evaluate country-level, regional, and global coverage of HIV...

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Veröffentlicht in:The Lancet global health 2023-12, Vol.11 (12), p.e1885-e1898
Hauptverfasser: Hajarizadeh, Behzad, Kairouz, Abe, Ottaviano, Sophie, Ireland, Jeremy, Willing, Alex, Cunningham, Evan, Webb, Paige, Colledge-Frisby, Samantha, Wheeler, Alice, Leung, Janni, Tran, Lucy T, Price, Olivia, Vickerman, Peter, Farrell, Michael, Hickman, Matthew, Dore, Gregory J, Bergenström, Anne, Degenhardt, Louisa, Grebely, Jason
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container_end_page e1898
container_issue 12
container_start_page e1885
container_title The Lancet global health
container_volume 11
creator Hajarizadeh, Behzad
Kairouz, Abe
Ottaviano, Sophie
Ireland, Jeremy
Willing, Alex
Cunningham, Evan
Webb, Paige
Colledge-Frisby, Samantha
Wheeler, Alice
Leung, Janni
Tran, Lucy T
Price, Olivia
Vickerman, Peter
Farrell, Michael
Hickman, Matthew
Dore, Gregory J
Bergenström, Anne
Degenhardt, Louisa
Grebely, Jason
description People who inject drugs are disproportionately affected by HIV and hepatitis C virus (HCV) infections, while there is little global data on HIV and HCV testing and treatment coverage of this population. We conducted a systematic review to evaluate country-level, regional, and global coverage of HIV and HCV testing and treatment among people who inject drugs. We did a systematic review, and searched bibliographic databases (MEDLINE, Embase, and PsycINFO) and grey literature for studies published between Jan 1, 2017, and April 30, 2022, that evaluated the proportion of people who inject drugs who received testing or treatment for HIV or HCV. For each country, we estimated the proportion of people who inject drugs tested for HIV antibodies in the past 12 months (recent), people who inject drugs ever tested for HCV antibodies and HCV RNA, people who inject drugs with HIV currently receiving antiretroviral therapy, and people who inject drugs with HCV ever receiving HCV antiviral treatment. Regional and global estimates, weighted by the population size of people who inject drugs, were generated where sufficient data were available. This study is registered with PROSPERO (CRD42020173974). 512 documents reported data eligible for analyses, including 337 peer-reviewed articles, 27 conference abstracts or presentations, and 148 documents from grey literature or supplementary searches. Data of recent HIV antibody testing were available for 67 countries and ever having had HCV antibody testing were available for 49 countries. Globally, an estimated 48·8% of people who inject drugs were recently tested for HIV antibodies (95% uncertainty interval [UI] 43·3–54·2%; range 0·9–86·0%), and 47·1% had ever been tested for HCV antibodies (95% UI 43·4–51·0%; range 0·0–93·3%). HCV RNA testing data were available from three countries. Coverage of HIV antibody testing was high (>75%) in four countries and for HCV antibody testing in 15 countries. The estimated uptake of current HIV treatment (18 countries) ranged from 2·6% to 81·9%, and the estimated uptake of ever having HCV treatment (23 countries) ranged from 1·8% to 88·6% across countries. Uptake of HIV treatment was high in two countries, and of HCV treatment in one country. HIV and HCV testing and treatment uptake among people who inject drugs was highly variable, and suboptimal in most countries. Strategies to improve access to HIV and HCV care among people who inject drugs and the availability of public health surveillanc
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We conducted a systematic review to evaluate country-level, regional, and global coverage of HIV and HCV testing and treatment among people who inject drugs. We did a systematic review, and searched bibliographic databases (MEDLINE, Embase, and PsycINFO) and grey literature for studies published between Jan 1, 2017, and April 30, 2022, that evaluated the proportion of people who inject drugs who received testing or treatment for HIV or HCV. For each country, we estimated the proportion of people who inject drugs tested for HIV antibodies in the past 12 months (recent), people who inject drugs ever tested for HCV antibodies and HCV RNA, people who inject drugs with HIV currently receiving antiretroviral therapy, and people who inject drugs with HCV ever receiving HCV antiviral treatment. Regional and global estimates, weighted by the population size of people who inject drugs, were generated where sufficient data were available. This study is registered with PROSPERO (CRD42020173974). 512 documents reported data eligible for analyses, including 337 peer-reviewed articles, 27 conference abstracts or presentations, and 148 documents from grey literature or supplementary searches. Data of recent HIV antibody testing were available for 67 countries and ever having had HCV antibody testing were available for 49 countries. Globally, an estimated 48·8% of people who inject drugs were recently tested for HIV antibodies (95% uncertainty interval [UI] 43·3–54·2%; range 0·9–86·0%), and 47·1% had ever been tested for HCV antibodies (95% UI 43·4–51·0%; range 0·0–93·3%). HCV RNA testing data were available from three countries. Coverage of HIV antibody testing was high (&gt;75%) in four countries and for HCV antibody testing in 15 countries. 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This study is registered with PROSPERO (CRD42020173974). 512 documents reported data eligible for analyses, including 337 peer-reviewed articles, 27 conference abstracts or presentations, and 148 documents from grey literature or supplementary searches. Data of recent HIV antibody testing were available for 67 countries and ever having had HCV antibody testing were available for 49 countries. Globally, an estimated 48·8% of people who inject drugs were recently tested for HIV antibodies (95% uncertainty interval [UI] 43·3–54·2%; range 0·9–86·0%), and 47·1% had ever been tested for HCV antibodies (95% UI 43·4–51·0%; range 0·0–93·3%). HCV RNA testing data were available from three countries. Coverage of HIV antibody testing was high (&gt;75%) in four countries and for HCV antibody testing in 15 countries. 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subjects Australia
Drug Users
Hepacivirus
Hepatitis C - diagnosis
Hepatitis C - drug therapy
Hepatitis C - epidemiology
Hepatitis C Antibodies - therapeutic use
HIV Antibodies - therapeutic use
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - prevention & control
HIV-1
Humans
RNA - therapeutic use
Substance Abuse, Intravenous - complications
Substance Abuse, Intravenous - epidemiology
title Global, regional, and country-level coverage of testing and treatment for HIV and hepatitis C infection among people who inject drugs: a systematic review
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