INTRODUCTION: High rates of hepatitis C virus (HCV) transmission are found in samples of people who inject drugs (PWID) throughout the world. The objective of this paper was to meta-analyze the effects of risk-reduction interventions on HCV seroconversion and identify the most effective intervention types. METHODS: We performed a systematic review and meta-analysis of published and unpublished studies. Eligible studies reported on the association between participation in interventions intended to reduce unsafe drug injection and HCV seroconversion in samples of PWID. RESULTS: The meta-analysis included 26 eligible studies of behavioral interventions, substance-use treatment, syringe access, syringe disinfection, and multicomponent interventions. Interventions using multiple combined strategies reduced risk of seroconversion by 75% (pooled relative risk, .25; 95% confidence interval, .07-.83). Effects of single-method interventions ranged from .6 to 1.6. CONCLUSIONS: Interventions using strategies that combined substance-use treatment and support for safe injection were most effective at reducing HCV seroconversion. Determining the effective dose and combination of interventions for specific subgroups of PWID is a research priority. However, our meta-analysis shows that HCV infection can be prevented in PWID.
INTRODUCTION: High rates of hepatitis C virus (HCV) transmission are found in samples of people who inject drugs (PWID) throughout the world. The objective of this paper was to meta-analyze the effects of risk-reduction interventions on HCV seroconversion and identify the most effective intervention types. METHODS: We performed a systematic review and meta-analysis of published and unpublished studies. Eligible studies reported on the association between participation in interventions intended to reduce unsafe drug injection and HCV seroconversion in samples of PWID. RESULTS: The meta-analysis included 26 eligible studies of behavioral interventions, substance-use treatment, syringe access, syringe disinfection, and multicomponent interventions. Interventions using multiple combined strategies reduced risk of seroconversion by 75% (pooled relative risk, .25; 95% confidence interval, .07-.83). Effects of single-method interventions ranged from .6 to 1.6. CONCLUSIONS: Interventions using strategies that combined substance-use treatment and support for safe injection were most effective at reducing HCV seroconversion. Determining the effective dose and combination of interventions for specific subgroups of PWID is a research priority. However, our meta-analysis shows that HCV infection can be prevented in PWID.
Authors: Norah Palmateer; Jo Kimber; Matthew Hickman; Sharon Hutchinson; Tim Rhodes; David Goldberg Journal: Addiction Date: 2010-03-02 Impact factor: 6.526
Authors: D M Patrick; M W Tyndall; P G Cornelisse; K Li; C H Sherlock; M L Rekart; S A Strathdee; S L Currie; M T Schechter; M V O'Shaughnessy Journal: CMAJ Date: 2001-10-02 Impact factor: 8.262
Authors: Charlotte H S B van den Berg; Colette Smit; Margreet Bakker; Ronald B Geskus; Ben Berkhout; Suzanne Jurriaans; Roel A Coutinho; Katja C Wolthers; Maria Prins Journal: Eur J Epidemiol Date: 2007-03-03 Impact factor: 8.082
Authors: Asher J Schranz; Jessica Barrett; Christopher B Hurt; Carlos Malvestutto; William C Miller Journal: Curr HIV/AIDS Rep Date: 2018-06 Impact factor: 5.071
Authors: Sean M Murphy; Jared A Leff; Benjamin P Linas; Jake R Morgan; Kathryn McCollister; Bruce R Schackman Journal: Subst Abus Date: 2018 Impact factor: 3.716
Authors: Jason Grebely; Geert Robaeys; Philip Bruggmann; Alessio Aghemo; Markus Backmund; Julie Bruneau; Jude Byrne; Olav Dalgard; Jordan J Feld; Margaret Hellard; Matthew Hickman; Achim Kautz; Alain Litwin; Andrew R Lloyd; Stefan Mauss; Maria Prins; Tracy Swan; Martin Schaefer; Lynn E Taylor; Gregory J Dore Journal: Int J Drug Policy Date: 2015-07-17