The University of Bristol-led research highlights the need for countries to increase measurement and monitoring of HIV and hepatitis C virus incidence among people who inject drugs, a high-risk population. The study emphasizes the need to prioritize this group in prevention and elimination work and to develop age-appropriate and gender-appropriate prevention measures. Limited data globally on HIV and hepatitis C virus incidence among people who inject drugs hampers the global effort to eliminate these viruses by 2030. Therefore, countries need to scale-up monitoring and measurement efforts to validate recommended targets for ending the HIV/AIDS epidemic and eliminating hepatitis C as a public health threat by 2030. The paper underscores the utility of routine collected programmatic data for documenting decreases in HIV incidence in challenging settings, and for improving the evidence base for how progress is being made towards elimination. The study’s findings suggest a pressing need for most countries to address these epidemics among people who inject drugs to avoid overlooking them when prevention and treatment strategies are put in place.
Monitoring HIV and HCV Incidence among People Who Inject Drugs Must Intensify to Achieve Global Elimination Goals
New research conducted by the University of Bristol-led team reveals that tracking HIV and Hepatitis C virus (HCV) incidence among people who inject drugs is crucial in achieving the global elimination goals. The study, published online in The Lancet Gastroenterology & Hepatology, highlights the need for countries to prioritize this high-risk group in prevention and elimination efforts.
To validate the recommended targets for ending the HIV/AIDS epidemic and eliminating HCV as a public health threat by 2030, countries must measure HIV and HCV incidence and document a decline over time, as suggested by UNAIDS and WHO. Given that people who inject drugs are among the key risk groups for HIV and HCV infection, tracking their incidence rate is vital.
The researchers conducted a systematic review and meta-analysis of studies published between 2000 and 2022 to summarise the global HIV and primary HCV incidence data among people who inject drugs, along with age- and sex-specific incidence data. They found that globally, only 14% and 12% of countries have at least one estimate on HIV and HCV incidence in this population, respectively. The estimates available were not recent, not nationally representative, and were often limited to a city within a country.
The study also revealed that the availability of estimates was geographically skewed, with few estimates from middle-income countries for HCV, and only one HIV and HCV incidence estimate from low-income countries. Available data, albeit limited, suggest that HIV and HCV incidence are high in this population, with an average of 1.7 and 12.1 per 100 person per year for HIV and HCV, respectively. These figures indicate that, on average, nearly 2 out of 100 people who inject drugs uninfected with HIV and HCV would acquire HIV, while 12 would acquire HCV if followed for one year. However, these estimates had considerable variability, with ranges of 0.1-31.8 per 100 person per year for HIV and 0.2-72.5 per 100 person per year for HCV.
Moreover, young people who inject drugs were found to have a 1.5-times greater risk of HIV and HCV than older people who inject drugs, while women had a 1.4-times greater risk of HIV and a 1.2-times greater risk of HCV than men.
In conclusion, the study highlights the need for countries to intensify their efforts to track HIV and HCV incidence among people who inject drugs and prioritize this group in prevention and elimination work. By doing so, countries can validate the recommended targets by UNAIDS and WHO for ending the HIV/AIDS epidemic and eliminating HCV as a public health threat by 2030.
Urgent Need to Scale-Up HIV and HCV Incidence Monitoring among People Who Inject Drugs
The need to prioritize people who inject drugs in prevention and elimination efforts for HIV and Hepatitis C virus (HCV) is urgent, as highlighted by a new study led by the University of Bristol. The research shows that most countries must scale-up measurement and monitoring of HIV and HCV incidence in this population, given their increased risk of infection. The study’s findings also reveal that young people and women who inject drugs are at higher risk of getting infected with both viruses.
Dr Adelina Artenie, Senior Research Associate in Mathematical Epidemiology at Bristol Medical School: Population Health Sciences (PHS), emphasized the challenges and expenses involved in measuring HIV and HCV incidence, explaining that this may be the reason why so few estimates are available globally. She underscored the importance of understanding the true scale of these epidemics among people who inject drugs to avoid overlooking them when prevention and treatment strategies are put in place.
The lack of data on HIV and HCV incidence among people who inject drugs globally remains a significant issue, as highlighted by Peter Vickerman, Professor of Infectious Disease Modelling from Bristol Medical School: PHS and NIHR Health Protection Research Unit (NIHR HPRU), who explained the need to improve interventions for this vulnerable group and collect data to show progress towards elimination. Routine collected programmatic data, including repeat HIV and/or HCV testing, could be used to estimate incidence rates and trends over time.
The previous study done by the research team has shown the utility of this type of data for documenting decreases in HIV incidence in challenging settings, highlighting its under-utilisation. These results offer a way forward for improving the evidence base towards elimination.
Conclusions
The study emphasizes the need for countries to prioritize people who inject drugs in HIV and HCV prevention and elimination efforts, given their increased risk of infection. The lack of data on the scale of these epidemics among this population remains a significant issue, requiring countries to scale-up monitoring and measurement efforts to validate recommended targets for ending the HIV/AIDS epidemic and eliminating HCV as a public health threat by 2030. Routine collected programmatic data could be used to estimate incidence rates and trends over time, improving the evidence base towards elimination.
Funding Sources for the Study on Incidence of HIV and Hepatitis C Virus among People Who Inject Drugs
The study, titled “Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis,” was funded by several organizations, including the Canadian Institutes of Health Research, Fonds de recherche du Québec-Santé, Canadian Network on Hepatitis C, National Institute for Health and Care Research, and WHO. The paper, authored by Adelina Artenie, Peter Vickerman, and others, is available in The Lancet Gastroenterology & Hepatology.
Don’t miss interesting posts on Famousbio
