People who inject drugs (PWID) are a key population affected by the hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor.
To coincide with World Hepatitis Day, the open-access online journal PLOS ONE publishes the results of an EMCDDA systematic review on data for the scaling up of HCV treatment and prevention for PWID across the European Union.
The study, one of the largest conducted on this topic and involving over 80 collaborators, concludes that data on HCV epidemiology, care and disease burden among PWID in Europe, while sparse, suggest many undiagnosed infections and poor treatment uptake. The burden of disease, where assessed, was high and is expected to rise in the next decade.
The authors reviewed the published literature from 2000, as well as data provided by the agency’s drug-related infectious diseases (DRID) expert network. Data availability was found to be highly variable across countries and topic areas, while important limitations exist both in comparability and representativeness. Below are some of the findings:
- HCV incidence among PWID was often high, with over one in ten PWID newly infected per year of exposure (range 2.7–66).
- Chronicity rates vary both above and under the expected 75% (range 53–97%), suggesting the existence of country differences.
- Genotypes 1 and 3 predominate among PWID, but 4 appears to be increasing, while the proportion of ‘difficult to treat’ genotypes (1+4) shows large variation (17–91%, median 53%).
- HIV prevalence in HCV-infected PWID varies widely (0–70%, median 3.9%).
- Half of the chronically infected PWID were unaware of their infection (median 49%, range 24–76%), and, of those diagnosed, only one in ten entered treatment for Hepatitis C (median 9.5%, range 1–19%).
The study concludes that stronger efforts are needed to improve data availability to guide the scale-up of HCV treatment among PWID.
28 July: World Hepatitis Day
‘Hepatitis: Think again’ is the theme of this year’s World Hepatitis Day. Viral hepatitis kills 1.5 million people worldwide each year, as many as those killed by HIV/AIDS. But for the world’s eighth biggest killer, viral hepatitis is remarkably neglected. For this reason, the World Health Organization made World Hepatitis Day one of only four official disease-specific world health days, to be commemorated each year on 28 July. Millions of people across the world now take part in World Hepatitis Day to raise awareness about viral hepatitis and to call for access to treatment, better prevention programmes and government action.
Figures from http://worldhepatitisday.org/
See also http: //www.who.int/campaigns/hepatitis-day/2014/en/
and #thinkhepatitis
