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The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa.

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Title: The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa.
Authors: Mahmud, Sarwat (AUTHOR), Mumtaz, Ghina R. (AUTHOR), Chemaitelly, Hiam (AUTHOR), Al Kanaani, Zaina (AUTHOR), Kouyoumjian, Silva P. (AUTHOR), Hermez, Joumana G. (AUTHOR), Abu‐Raddad, Laith J. (AUTHOR)
Source: Addiction. Jul2020, Vol. 115 Issue 7, p1244-1262. 19p. 3 Charts.
Subjects: Hepatitis C virus, Intravenous drug abuse, Genotypes, Hepatitis C risk factors
Geographic Terms: Middle East, North Africa
Abstract: Background and aims: People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA). Methods: Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989–2018. Random‐effects meta‐analyses and meta‐regressions were performed. Meta‐regression variables included country, study site, year of data collection and year of publication [to assess trends in HCV antibody prevalence over time], sample size and sampling methodology. Numbers of chronically infected PWID across MENA were estimated. The Shannon Diversity Index was calculated to assess genotype diversity. Results: Based on 118 HCV antibody prevalence measures, the pooled mean prevalence in PWID for all MENA was 49.3% [95% confidence interval (CI) = 44.4–54.1%]. The country‐specific pooled mean ranged from 21.7% (95% CI = 4.9–38.6%) in Tunisia to 94.2% (95% CI = 90.8–96.7%) in Libya. An estimated 221 704 PWID were chronically infected, with the largest numbers found in Iran at 68 526 and in Pakistan at 46 554. There was no statistically significant evidence for a decline in HCV antibody prevalence over time. Genotype diversity was moderate (Shannon Diversity Index of 1.01 out of 1.95; 52.1%). The pooled mean percentage for each HCV genotype was highest in genotype 3 (42.7%) and in genotype 1 (35.9%). Conclusion: Half of people who inject drugs in the Middle East and North Africa appear to have ever been infected with hepatitis C virus, but there are large variations in antibody prevalence among countries. In addition to > 200 000 chronically infected current people who inject drugs, there is an unknown number of people who no longer inject drugs who may have acquired hepatitis C virus during past injecting drug use. Harm reduction services must be expanded, and innovative strategies need to be employed to ensure accessibility to hepatitis C virus testing and treatment. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa.
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  Data: <searchLink fieldCode="AR" term="%22Mahmud%2C+Sarwat%22">Mahmud, Sarwat</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mumtaz%2C+Ghina+R%2E%22">Mumtaz, Ghina R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chemaitelly%2C+Hiam%22">Chemaitelly, Hiam</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Al+Kanaani%2C+Zaina%22">Al Kanaani, Zaina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kouyoumjian%2C+Silva+P%2E%22">Kouyoumjian, Silva P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hermez%2C+Joumana+G%2E%22">Hermez, Joumana G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Abu‐Raddad%2C+Laith+J%2E%22">Abu‐Raddad, Laith J.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Jul2020, Vol. 115 Issue 7, p1244-1262. 19p. 3 Charts.
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  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Hepatitis+C+virus%22">Hepatitis C virus</searchLink><br /><searchLink fieldCode="DE" term="%22Intravenous+drug+abuse%22">Intravenous drug abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Genotypes%22">Genotypes</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+risk+factors%22">Hepatitis C risk factors</searchLink>
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  Label: Geographic Terms
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  Data: <searchLink fieldCode="DE" term="%22Middle+East%22">Middle East</searchLink><br /><searchLink fieldCode="DE" term="%22North+Africa%22">North Africa</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and aims: People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA). Methods: Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989–2018. Random‐effects meta‐analyses and meta‐regressions were performed. Meta‐regression variables included country, study site, year of data collection and year of publication [to assess trends in HCV antibody prevalence over time], sample size and sampling methodology. Numbers of chronically infected PWID across MENA were estimated. The Shannon Diversity Index was calculated to assess genotype diversity. Results: Based on 118 HCV antibody prevalence measures, the pooled mean prevalence in PWID for all MENA was 49.3% [95% confidence interval (CI) = 44.4–54.1%]. The country‐specific pooled mean ranged from 21.7% (95% CI = 4.9–38.6%) in Tunisia to 94.2% (95% CI = 90.8–96.7%) in Libya. An estimated 221 704 PWID were chronically infected, with the largest numbers found in Iran at 68 526 and in Pakistan at 46 554. There was no statistically significant evidence for a decline in HCV antibody prevalence over time. Genotype diversity was moderate (Shannon Diversity Index of 1.01 out of 1.95; 52.1%). The pooled mean percentage for each HCV genotype was highest in genotype 3 (42.7%) and in genotype 1 (35.9%). Conclusion: Half of people who inject drugs in the Middle East and North Africa appear to have ever been infected with hepatitis C virus, but there are large variations in antibody prevalence among countries. In addition to > 200 000 chronically infected current people who inject drugs, there is an unknown number of people who no longer inject drugs who may have acquired hepatitis C virus during past injecting drug use. Harm reduction services must be expanded, and innovative strategies need to be employed to ensure accessibility to hepatitis C virus testing and treatment. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/add.14944
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        Text: English
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      – SubjectFull: Hepatitis C virus
        Type: general
      – SubjectFull: Intravenous drug abuse
        Type: general
      – SubjectFull: Genotypes
        Type: general
      – SubjectFull: Hepatitis C risk factors
        Type: general
      – SubjectFull: Middle East
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      – SubjectFull: North Africa
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              Text: Jul2020
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              Y: 2020
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