Review and meta-analysis of the association between self-reported sharing of needles/syringes and hepatitis C virus prevalence and incidence among people who inject drugs in Europe

Norah Elizabeth Palmateer, Sharon Hutchinson, Hamish Innes, Christian Schnier, Olivia Wu, Goldberg David J., Matthew Hickman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Although sharing needles/syringes (N/S) is a recognised risk factor for the hepatitis C virus (HCV), epidemiological studies have shown inconsistent associations between self-reported N/S sharing and biological markers of HCV infection. This review aims to summarise, and explore factors that may explain the variation in, the measure of association between self-reported sharing of N/S and HCV prevalence/incidence among people who inject drugs (PWID).
Studies undertaken in Europe during 1990-2011 were identified through an electronic literature search. Eligible studies reported HCV prevalence (or incidence) among those who reported ever/never (or recent/non-recent) sharing of N/S. Meta-analysis was undertaken to generate a pooled estimate of the association and heterogeneity was explored using stratified analyses.
Sixteen cross-sectional studies and four longitudinal studies were included. Pooled prevalence and incidence of HCV was 59% and 11% among PWID who reported never and not recently sharing N/S, respectively. Random effects meta-analysis generated a pooled odds ratio (OR) of 3.3 (95% CI 2.4-4.6), comparing HCV infection among those who ever (or recently) shared N/S relative to those who reported never (or not recently) sharing. There was substantial heterogeneity between the study effect sizes (I(2)=72.8%). Differences in pooled ORs were found when studies were stratified by recruitment setting (prison vs. drug treatment sites), recruitment method (outreach vs. non-outreach), sample HCV prevalence and sample mean/median time since onset of injecting.
We found high incidence/prevalence rates among those who did not report sharing N/S during the risk period, which may be due to a combination of unmeasured risk factors and reporting bias. Study design and population are likely to be important modifiers of the size and strength of association between HCV and N/S sharing.

LanguageEnglish
Pages85-100
Number of pages16
JournalInternational Journal of Drug Policy
Volume24
Issue number2
Early online date28 Sep 2012
DOIs
Publication statusPublished - Mar 2013

Fingerprint

Needle Sharing
Hepacivirus
Meta-Analysis
Incidence
Pharmaceutical Preparations
Virus Diseases
Prisons
Syringes
Needles
Longitudinal Studies
Epidemiologic Studies

Keywords

  • hepatitis C virus
  • injecting drug users

Cite this

Palmateer, Norah Elizabeth ; Hutchinson, Sharon ; Innes, Hamish ; Schnier, Christian ; Wu, Olivia ; David J., Goldberg ; Hickman, Matthew. / Review and meta-analysis of the association between self-reported sharing of needles/syringes and hepatitis C virus prevalence and incidence among people who inject drugs in Europe. In: International Journal of Drug Policy. 2013 ; Vol. 24, No. 2. pp. 85-100.
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Review and meta-analysis of the association between self-reported sharing of needles/syringes and hepatitis C virus prevalence and incidence among people who inject drugs in Europe. / Palmateer, Norah Elizabeth; Hutchinson, Sharon; Innes, Hamish; Schnier, Christian; Wu, Olivia; David J., Goldberg; Hickman, Matthew.

In: International Journal of Drug Policy, Vol. 24, No. 2, 03.2013, p. 85-100.

Research output: Contribution to journalArticle

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