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Meta-Analysis
. 2015 Nov:40:116-30.
doi: 10.1016/j.ijid.2015.09.022. Epub 2015 Oct 13.

High hepatitis C virus prevalence among drug users in Iran: systematic review and meta-analysis of epidemiological evidence (2001-2012)

Mohsen Malekinejad  1 , Soodabeh Navadeh  2 , Ali Lotfizadeh  3 , Afarin Rahimi-Movaghar  4 , Masoumeh Amin-Esmaeili  5 , Alireza Noroozi  6
Affiliations
Meta-Analysis

High hepatitis C virus prevalence among drug users in Iran: systematic review and meta-analysis of epidemiological evidence (2001-2012)

Mohsen Malekinejad et al. Int J Infect Dis. 2015 Nov.

Abstract

Objective: Drug users, particularly drug injectors, are at elevated risk of blood-borne diseases. This study systematically reviewed the prevalence of hepatitis C virus (HCV) mono-infection and its co-infections with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in drug users in Iran.

Methods: Searches were conducted in international, regional, and Iranian databases. Documents were screened, data extracted, and pooled point prevalence and 95% confidence intervals (CI) were calculated.

Results: Overall, 13,821 subjects (87.4% male) with an average age of 32.4 years (95% CI 31-33 years) from 24 original studies were included in the analysis. The pooled HCV prevalence (95% CI) among drug users with and without an injection history was 45% (37-54%) and 8% (4-13%), respectively. The pooled HCV prevalences (95% CI) among individuals with vs. without a history of imprisonment and needle sharing were 58% (39-77%) vs. 44% (20-68%) and 56% (41-71%) vs. 49% (26-71%), respectively. The prevalence of HCV/HIV co-infection among injectors was 11% (95% CI 5-16%).

Conclusions: HCV prevalence is high in drug users in Iran, especially among those with a history of injection drug use, needle sharing, and imprisonment. Drug user-focused HCV prevention and treatment programs are urgently needed.

Keywords: Drug use; HIV; Harm reduction; Hepatitis B; Hepatitis C; Iran.

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Figures

Figure 1
Figure 1. Search Results
Number of studies identified at each step of searching, screening, and data extraction
Figure 2
Figure 2. HCV prevalence in drug users who inject
Summary estimate of HCV infection prevalence and 95% CI among people who inject drugs, by timing of injection
Figure 3
Figure 3. HCV prevalence in drug users who do not inject
Summary estimate of HCV infection prevalence and 95% CI among drug users who have never injected
Figure 4
Figure 4. HCV co-infection prevalence
Summary estimate of HCV/HIV (top) and HCV/HBV (bottom) co-infection prevalence and 95% CI by drug use pattern
Figure 5
Figure 5. HCV prevalence in different cities/settings
Summary estimate of HCV infection prevalence and 95% CI among injection drug users, stratified by city (top) and study settings (bottom)
See this image and copyright information in PMC

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