TY - JOUR
T1 - Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China
T2 - A systematic review and meta-analysis
AU - Bao, Yanping
AU - Larney, Sarah
AU - Peacock, Amy
AU - Colledge, Samantha
AU - Grebely, Jason
AU - Hickman, Matthew
AU - Degenhardt, Louisa
AU - Leung, Janni
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - BACKGROUND: Globally, China is the largest country by population and contributes substantially to the burden of people who inject drugs (PWID). The aims of this study were to estimate the prevalence of HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV) among PWID at the national and subnational level in China and examine characteristics of PWID.METHODS: We undertook a systematic review of studies published from 2008 to 2017 on HIV, HCV, and HBV seroprevalence among PWID, and characteristics of PWID in Mainland China, Hong Kong, Macao and Taiwan. Meta-analyses were conducted to generate pooled prevalence estimates by province, region, and nationally.RESULTS: Eighty-five papers were included. The pooled HIV, HCV antibody and HBV prevalence among PWID in China was 10.5% (95% confidence interval [95%CI]: 8.6%-12.5%), 71.6% (65.7%-77.6%) and 19.6% (13.7%-25.5%), respectively. In Mainland China, HIV prevalence was highest in the Southwest (14.4%, 10.5%-18.4%) and lowest in the North (1.3%, 0.4%-3.4%). Xinjiang Province had the highest HIV prevalence (42.6%, 35.5%-49.8%). HCV antibody prevalence was highest in the Southwest (77.7%, 69.9%-85.4%), followed by South (76.2%, 65.9%-86.4%). Sichuan had the highest HCV antibody prevalence (91.7%, 86.6%-95.3%), followed by Guangxi (86.1%, 81.8%-90.4%). HBsAg prevalence among PWID was highest in South (25.3%, 14.6%-36.0%), followed by Central (20.8%, 17.4%-24.1%). HBsAg prevalence ranged from 2.4% (0.6-5.9%) in Guizhou to 40.0% (33.7%-46.6%) in Shannxi Province. In China, women and young people accounted for 21.3% and 23.1% of PWID, respectively. It was estimated that 96.1% of PWID injected opioids mainly, and recent injecting risk and sexual risk was reported by 28.5% and 36.7%.CONCLUSION: There is a large burden of HIV, HCV and HBV prevalence among PWID in China, with considerable geographic variation. The disease burden of viral hepatitis is particularly high, implying that effective management should be integrated into harm reduction interventions among PWID in China.
AB - BACKGROUND: Globally, China is the largest country by population and contributes substantially to the burden of people who inject drugs (PWID). The aims of this study were to estimate the prevalence of HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV) among PWID at the national and subnational level in China and examine characteristics of PWID.METHODS: We undertook a systematic review of studies published from 2008 to 2017 on HIV, HCV, and HBV seroprevalence among PWID, and characteristics of PWID in Mainland China, Hong Kong, Macao and Taiwan. Meta-analyses were conducted to generate pooled prevalence estimates by province, region, and nationally.RESULTS: Eighty-five papers were included. The pooled HIV, HCV antibody and HBV prevalence among PWID in China was 10.5% (95% confidence interval [95%CI]: 8.6%-12.5%), 71.6% (65.7%-77.6%) and 19.6% (13.7%-25.5%), respectively. In Mainland China, HIV prevalence was highest in the Southwest (14.4%, 10.5%-18.4%) and lowest in the North (1.3%, 0.4%-3.4%). Xinjiang Province had the highest HIV prevalence (42.6%, 35.5%-49.8%). HCV antibody prevalence was highest in the Southwest (77.7%, 69.9%-85.4%), followed by South (76.2%, 65.9%-86.4%). Sichuan had the highest HCV antibody prevalence (91.7%, 86.6%-95.3%), followed by Guangxi (86.1%, 81.8%-90.4%). HBsAg prevalence among PWID was highest in South (25.3%, 14.6%-36.0%), followed by Central (20.8%, 17.4%-24.1%). HBsAg prevalence ranged from 2.4% (0.6-5.9%) in Guizhou to 40.0% (33.7%-46.6%) in Shannxi Province. In China, women and young people accounted for 21.3% and 23.1% of PWID, respectively. It was estimated that 96.1% of PWID injected opioids mainly, and recent injecting risk and sexual risk was reported by 28.5% and 36.7%.CONCLUSION: There is a large burden of HIV, HCV and HBV prevalence among PWID in China, with considerable geographic variation. The disease burden of viral hepatitis is particularly high, implying that effective management should be integrated into harm reduction interventions among PWID in China.
KW - China
KW - HBV
KW - HCV
KW - HIV
KW - Meta-analysis
KW - People who inject drugs
UR - http://www.scopus.com/inward/record.url?scp=85065826023&partnerID=8YFLogxK
U2 - 10.1016/j.drugpo.2019.05.005
DO - 10.1016/j.drugpo.2019.05.005
M3 - Review article (Academic Journal)
C2 - 31125802
SN - 0955-3959
VL - 70
SP - 87
EP - 93
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
ER -