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Cited by 104Hepatitis C virus researchHIV, Drug Use, Sexual RiskLiver Disease Diagnosis and Treatment

The DOI matches its Crossref record; 76 of the 76 references it cites were found in a registry or an index.

Hepatitis C virus (HCV) disease progression in people who inject drugs (PWID): A systematic review and meta-analysis

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Smith, Daniel J., Combellick, Joan, Jordan, Ashly E., Hagan, Holly·2015·International Journal of Drug Policy
DOI 10.1016/j.drugpo.2015.07.004PMC PMC4577462
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Abstract

Background Understanding HCV disease progression rates among people who inject drugs (PWID) is important to setting policy to expand access to detection, diagnosis and treatment, and in forecasting the burden of disease. In this paper we synthesize existing data on the natural history of HCV among PWID, including fibrosis progression rates (FPR) and the incidence of compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC). Methods We conducted electronic and manual searches for published and unpublished literature. Reports were eligible if they (i) included participants who were chronically infected with HCV and reported current or previous injection drug use; (ii) presented original data on disease progression in a study sample comprised of at least 90% PWID; (iii) published between January 1, 1990, and December 31, 2013; and (iv) included data from upper-middle- or high-income countries. Quality ratings were assigned using an adaptation of the Quality In Prognosis Studies (QUIPS) tool. We estimated pooled FPRs using the stage-constant and stage-specific methods, and pooled incidence rates of CC, DC, and HCC. Results Twenty-one reports met the study inclusion criteria. Based on random-effect models, the pooled stage-constant FPR was 0.117 METAVIR units per year (95% CI, 0.099-0.135), and the stage-specific FPRs were F0→F1, 0.128 (95% CI 0.080, 0.176); F1→F2, 0.059 (95% CI 0.035, 0.082); F2→F3, 0.078 (95% CI 0.056, 0.100); and F3→F4, 0.116 (95% CI 0.070, 0.161). The pooled incidence rates of CC, DC, and HCC were 6.6 (95% CI 4.8, 8.4), 1.1 (95% CI 0.8, 1.4), and 0.3 (95% CI -0.1, 0.6) events per 1000 person-years, respectively. Following the stage-constant estimate, average time to cirrhosis is 34 years post-infection, and time to METAVIR stage F3 is 26 years; using the stage-specific estimates, time to cirrhosis is 46 years and time to F3 is 38 years. Conclusion Left untreated, PWID with chronic HCV infection will develop liver sequelae (including HCC) in mid- to late-adulthood. Delaying treatment with the new drug regimens until advanced fibrosis develops prolongs the period of infectiousness to perhaps thirty years. Scaling up of effective HCV prevention and early engagement in care and treatment will facilitate the elimination HCV as a source of serious disease in PWID.

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  1. Nelson, 2011, The epidemiology of viral hepatitis among people who inject drugs: Results of global systematic reviews, The Lancet Infectious Diseases, 378, 571

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Metadata

Authors
Smith, D. J., Combellick, J., Jordan, A. E., & Hagan, H.
Affiliations
  • New York University (US)
  • Center for Drug Use and HIV Research (US)
Corresponding author
Smith, Daniel J.
ORCID
Venue
International Journal of Drug Policy
Publisher
Elsevier BV
Published
2015-10
Volume
26
Issue
10
Pages
911-921
ISSN
0955-3959 (ISSN-L)
DOI
10.1016/j.drugpo.2015.07.004
PMC
PMC4577462
OpenAlex
W1941992522
Cited by
104
References
75
Citations by year
2026: 3 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 10 · 2021: 14 · 2020: 12 · 2019: 12 · 2018: 13 · 2017: 12 · 2016: 9 · 2015: 6
FWCI
1.91
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Drug Policy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R01DA034637, P30 DA011041)
Topics
  • Health Sciences › Medicine › Hepatology › Hepatitis C virus research
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Keywords
hepatitis C virus, people who inject drugs, liver fibrosis progression, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, METAVIR score, incidence rates, harm reduction, harm reduction services, harm reduction funding
MeSH terms
Carcinoma, Hepatocellular, Humans, Liver Cirrhosis, Liver Neoplasms, HIV Infections, Substance Abuse, Intravenous, Comorbidity, Incidence, Disease Progression, Hepatitis C, Chronic

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