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Meta‐analysis of hepatitis C seroconversion in relation to shared syringes and drug preparation equipment

Year: 2011
Type: review
Abstract: AIMS: We conducted a systematic review of studies reporting seroincidence of hepatitis C infection (HCV) in relation to shared syringes and drug preparation equipment among injection drug users (IDUs). We identified published and unpublished studies that met inclusion criteria. DESIGN: We estimated the relative contributions of shared syringes and drug preparation equipment to HCV transmission using random-effects meta-analysis, and analyzed potential sources of heterogeneity of effects among studies. FINDINGS: Syringe sharing was associated with HCV seroconversion [pooled risk ratio (PRR) = 1.94, 95% confidence interval (CI) 1.53, 2.46], as was sharing drug preparation containers (PRR = 2.42, 95% CI 1.89, 3.10), filters (PRR = 2.61, 95% CI 1.91, 3.56), rinse water (PRR = 1.98, 95% CI 1.54, 2.56), combinations of this equipment (PRR = 2.24, 95% CI 1.28, 3.93) and 'backloading', a syringe-mediated form of sharing prepared drugs (PRR = 1.86, 95% CI 1.41, 2.44). Meta-regression results showed that the association between syringe sharing and seroconversion was modified by HCV seroprevalence in the IDU populations. CONCLUSIONS: The risk of hepatitis C infection through shared syringes is dependent upon hepatitis C infection seroprevalence in the population. The risk of hepatitis C infection through shared drug preparation equipment is similar to that of shared syringes. Because the infection status of sharing partners is often unknown, it is important for injection drug users to consistently avoid sharing unsterile equipment used to prepare, divide or inject drugs and avoid backloading with an unsterile syringe.
Source: Addiction
DOI: 10.1111/j.1360-0443.2011.03765.x
Language: English
Subfield: Epidemiology
Field: Medicine
Open Access status: green
Award: G816537153
OpenAlex ID: W1886986863
FWCI: 1.17
Cites: 37
Cited by: 156
Related to: 10