Population Health Sciences, University of Bristol, Bristol, UK.
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
Drug Alcohol Rev. 2023 Mar;42(3):569-581. doi: 10.1111/dar.13595. Epub 2023 Jan 4.
Globally, hepatitis B virus (HBV) is a leading cause of liver disease. People who inject drugs (PWID) are at greater risk than the general population of contracting HBV. This risk could depend on societal factors in different countries. We investigated the associations between country-level chronic HBV prevalence in PWID with national indicators of development and prevalence of HIV and hepatitis C virus (HCV).
We used global systematic review data on chronic HBV prevalence (hepatitis B surface antigen-positive) among PWID and country-level sociodemographic characteristics from online databases. National random-effects meta-analysis estimates of HBV prevalence were the outcome in linear regression models testing for associations with country-level characteristics.
The study included 131,710 PWID from 304 estimates in 55 countries: the pooled HBV prevalence among PWID in the countries analysed was 4.5% (95% CI 3.9-5.1), the highest regional pooled prevalence was in East and Southeast Asia (17.6% [13.3-22.3]), and the lowest was in Western Europe (1.7% [1.4-2.1]). In multivariable models, no indicators of development were associated with HBV prevalence, but there was evidence of positive associations between HBV prevalence in the general population and among PWID, and evidence of HIV and HCV prevalence in PWID being associated with HBV prevalence in PWID: multivariable coefficients 0.03 (95% CI 0.01-0.04); p < 0.001, and 0.01 (95% CI 0.00-0.03); p = 0.01, respectively.
HBV prevalence among PWID was associated with HIV and HCV prevalence among PWID and background HBV prevalence in the general population, highlighting the need for improving harm reduction in PWID and implementation of HBV vaccination, especially where HBV is endemic.
在全球范围内，乙型肝炎病毒（HBV）是导致肝脏疾病的主要原因之一。与一般人群相比，注射毒品者（PWID）感染 HBV 的风险更高。这种风险可能取决于不同国家的社会因素。我们调查了慢性 HBV 在 PWID 中的流行率与国家发展指标以及 HIV 和丙型肝炎病毒（HCV）的流行率之间的关系。
我们使用了全球系统评价数据，该数据涉及 PWID 中慢性 HBV 流行率（乙型肝炎表面抗原阳性）以及来自在线数据库的国家社会人口统计学特征。国家随机效应荟萃分析估计的 HBV 流行率是线性回归模型中检验与国家特征相关性的结果。
该研究纳入了来自 55 个国家的 304 项估计中的 131710 名 PWID：分析国家中 PWID 的 HBV 总流行率为 4.5%（95%CI 3.9-5.1），最高的地区总流行率为东亚和东南亚（17.6%[13.3-22.3]），最低的是西欧（1.7%[1.4-2.1]）。在多变量模型中，没有发展指标与 HBV 流行率相关，但在普通人群和 PWID 中的 HBV 流行率之间存在正相关的证据，以及 PWID 中的 HIV 和 HCV 流行率与 PWID 中的 HBV 流行率相关的证据：多变量系数 0.03（95%CI 0.01-0.04）；p<0.001，和 0.01（95%CI 0.00-0.03）；p=0.01，分别。
PWID 中的 HBV 流行率与 PWID 中的 HIV 和 HCV 流行率以及普通人群中的背景 HBV 流行率相关，这突出表明需要改善 PWID 中的减少伤害和实施 HBV 疫苗接种，特别是在 HBV 流行的地方。
