Rafiq Shafquat Mohammed, Banik Gouri Rani, Khan Sabina, Rashid Harunor, Khandaker Gulam
National Centre for Immunisation Research and Surveillance (NCIRS), Kids research Institute, The Children Hospital at Westmead, Cnr Hawkesbury Road and Hainsworth Street, Westmead, Locked Bag 4001, Westmead NSW 2145, Australia.
Infect Disord Drug Targets. 2014;14(2):93-100. doi: 10.2174/1871526514666141014145612.
Hepatitis C virus (HCV) infection among injecting drug users (IDUs) is a major public health concern. It is important to know the current burden of HCV infection among IDUs for targeted public health interventions in this high risk population. We systematically reviewed the published literature on prevalence of HCV infections among IDUs between January 1989 and April 2014. Sixty studies met the inclusion criteria for the review and subsequent analysis. Among the selected studies 26,311 IDUs were assessed for HCV infection of which 16,231 were positive, giving an overall prevalence of 61.7% (95% Confidence Interval [95% CI] 61.1-62.3%). Of the selected studies, 21 were from Asia, 20 from Europe, 13 from Americas, 5 from Australia and one from Africa. Combined regional estimates of HCV prevalence among IDUs showed that Africa has the highest mean prevalence of HCV among IDUs (97.3%, 95% CI 95.5-98.4%), however, this estimate was based only on one study from Mauritius. Europe has the second highest mean prevalence (65.9%, 95% CI 64.9-66.9%) followed by Australia (56.5%, 95% CI 53.8-59.2%). Our review suggests that the prevalence of HCV among IDUs is significantly high. There are very limited data from African nations. More comprehensive understanding of HCV epidemiology among IDUs including the risk behaviours are needed for this high risk group.
注射吸毒者中的丙型肝炎病毒(HCV)感染是一个重大的公共卫生问题。了解注射吸毒者中HCV感染的当前负担对于针对这一高危人群开展公共卫生干预措施至关重要。我们系统回顾了1989年1月至2014年4月间发表的关于注射吸毒者中HCV感染患病率的文献。60项研究符合该综述及后续分析的纳入标准。在所选研究中,对26,311名注射吸毒者进行了HCV感染评估,其中16,231人呈阳性,总体患病率为61.7%(95%置信区间[95%CI]61.1 - 62.3%)。在所选研究中,21项来自亚洲,20项来自欧洲,13项来自美洲,5项来自澳大利亚,1项来自非洲。注射吸毒者中HCV患病率的综合区域估计显示,非洲注射吸毒者中HCV的平均患病率最高(97.3%,95%CI 95.5 - 98.4%),然而,这一估计仅基于毛里求斯的一项研究。欧洲的平均患病率次之(65.9%,95%CI 64.9 - 66.9%),其次是澳大利亚(56.5%,95%CI 53.8 - 59.2%)。我们的综述表明,注射吸毒者中HCV的患病率非常高。来自非洲国家的数据非常有限。对于这一高危群体,需要更全面地了解注射吸毒者中HCV的流行病学情况,包括其危险行为。