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Meta-Analysis
. 2016 Sep 5;16(1):471.
doi: 10.1186/s12879-016-1807-5.

Spontaneous viral clearance of hepatitis C virus (HCV) infection among people who inject drugs (PWID) and HIV-positive men who have sex with men (HIV+ MSM): a systematic review and meta-analysis

Daniel J Smith  1 , Ashly E Jordan  2   3 , Mayu Frank  2 , Holly Hagan  2   3
Affiliations
Meta-Analysis

Spontaneous viral clearance of hepatitis C virus (HCV) infection among people who inject drugs (PWID) and HIV-positive men who have sex with men (HIV+ MSM): a systematic review and meta-analysis

Daniel J Smith et al. BMC Infect Dis. .

Abstract

Background: Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM). Characterizing spontaneous viral clearance of HCV infection among PWID and HIV+ MSM is important for assessing the burden of disease and treatment strategies in these populations.

Methods: Electronic and other searches of medical literature were conducted. Reports were eligible if they presented original data from upper-middle- and high-income countries on laboratory-confirmed HCV infection and spontaneous viral clearance among PWID or HIV+ MSM. Pooled estimates of spontaneous viral clearance were generated using fixed-effect and random-effects models. Meta-regression examined potential predictors related to individual characteristics and research methodology.

Results: The meta-analysis estimated that spontaneous viral clearance occurs in 24.4 % of PWID and 15.4 % of HIV+ MSM. In univariate meta-regression among PWID, male sex and age were significantly associated with spontaneous viral clearance, and in multivariate analysis, male sex and HIV positivity were predictors of spontaneous viral clearance; among HIV+ MSM no variables were found to affect spontaneous viral clearance.

Conclusion: The variability in estimates of spontaneous viral clearance between HIV+ MSM and PWID suggests the impact of HIV co-infection and HCV re-infection. Due to limited data on additional factors that may affect the natural history of HCV, more research is needed to further understand spontaneous viral clearance in these risk groups.

Protocol registration: The protocols for the PWID and HIV+ MSM research were registered with PROSPERO (CRD42014008805; CRD42013006462).

Keywords: Hepatitis C virus; MSM; Meta-analysis; PWID; Spontaneous HCV clearance; Systematic review.

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Figures

Fig. 1
Fig. 1
Flow diagram of the literature search and eligibility assessment for PWID. 1Reasons for exclusion are not mutually exclusive. A report may have been ineligible due to multiple reasons. Here, only one reason for exclusion is provided
Fig. 2
Fig. 2
Forest plot of the estimated prevalence and 95 % CI of HCV clearance among PWID for each study
Fig. 3
Fig. 3
Flow diagram of the literature search and eligibility assessment for HIV+ MSM. 1Reasons for exclusion are not mutually exclusive. A report may have been ineligible due to multiple reasons. Here, only one reason for exclusion is provided
Fig. 4
Fig. 4
Forest plot of the estimated prevalence and 95 % CI of HCV clearance among HIV+ MSM for each study
See this image and copyright information in PMC

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References

    1. Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: New estimates of age‐specific antibody to HCV seroprevalence. Hepatology. 2013;57:1333–1342. doi: 10.1002/hep.26141. - DOI - PubMed
    1. Grebely J, Prins M, Hellard M, Cox AL, Osburn WO, Lauer G, et al. Hepatitis C virus clearance, reinfection, and persistence, with insights from studies of injecting drug users: towards a vaccine. Lancet Infect Dis. 2012;12:408–414. doi: 10.1016/S1473-3099(12)70010-5. - DOI - PMC - PubMed
    1. Hadigan C, Kottilil S. Hepatitis C virus infection and coinfection with human immunodeficiency virus: challenges and advancements in management. JAMA. 2011;306:294–301. doi: 10.1001/jama.2011.975. - DOI - PubMed
    1. Hajarizadeh B, Grebely J, Dore GJ. Epidemiology and natural history of HCV infection. Nat Rev Gastroenterol Hepatol. 2013;10:553–562. doi: 10.1038/nrgastro.2013.107. - DOI - PubMed
    1. Hagan H, Pouget ER, Williams IT, Garfein RL, Strathdee SA, Hudson SM, et al. Attribution of hepatitis C virus seroconversion risk in young injection drug users in 5 US cities. J Infect Dis. 2010;201:378–385. doi: 10.1086/649783. - DOI - PubMed