Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis

doi:10.1016/j.drugpo.2019.05.005

Meta-Analysis

. 2019 Aug:70:87-93.

doi: 10.1016/j.drugpo.201905005. Epub 2019 May 21.

Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis

Yanping Bao ¹, Sarah Larney ², Amy Peacock ², Samantha Colledge ², Jason Grebely ³, Matthew Hickman ⁴, Louisa Degenhardt ², Janni Leung ⁵

Affiliations

¹ National Institute on Drug Dependence, Peking University, Beijing, China; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
² National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
³ The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
⁴ Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia. Electronic address: j.leung1@uq.edu.au.

PMID: 31125802
PMCID: PMC6679982
DOI: 10.1016/j.drugpo.201905005

Meta-Analysis

Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis

Yanping Bao et al. Int J Drug Policy. 2019 Aug.

. 2019 Aug:70:87-93.

doi: 10.1016/j.drugpo.201905005. Epub 2019 May 21.

Authors

Yanping Bao ¹, Sarah Larney ², Amy Peacock ², Samantha Colledge ², Jason Grebely ³, Matthew Hickman ⁴, Louisa Degenhardt ², Janni Leung ⁵

Affiliations

¹ National Institute on Drug Dependence, Peking University, Beijing, China; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
² National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
³ The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
⁴ Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia. Electronic address: j.leung1@uq.edu.au.

PMID: 31125802
PMCID: PMC6679982
DOI: 10.1016/j.drugpo.201905005

Abstract

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.

Keywords: China; HBV; HCV; HIV; Meta-analysis; People who inject drugs.

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Figures

Fig. 1

Fig. 1

Flowchart of study identification and inclusion.

Figure 2

Figure 2

The pooled prevalence of HIV, anti-HCV and HBsAg among PWID in China ( 2008–2017)

See this image and copyright information in PMC

References

1. Bao Y, Du C, Lu H, Lian Z, Qiu Y, Mu Y, et al. (2012). The investigation of HIV and HCV infection and risk factors among opiate drug users in Beijing, China. American Journal of Drug & Alcohol Abuse 38, 140–145. - PubMed
1. Bao YP, Liu ZM (2009). Systematic review of HIV and HCV infection among drug users in China. International journal of STD & AIDS 20, 399–405. - PubMed
1. Degenhardt L, Charlson F, Stanaway J, Larney S, Alexander LT, Hickman M, et al. (2016). Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013. The Lancet Infectious diseases 16, 1385–1398. - PubMed
1. Degenhardt L, Mathers B, Vickerman P, Rhodes T, Latkin C, Hickman M (2010). Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed. Lancet (London, England) 376, 285–301. - PubMed
1. Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. (2017). Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global health 5, e1192–e1207. - PMC - PubMed

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[1] Bao Y, Du C, Lu H, Lian Z, Qiu Y, Mu Y, et al. (2012). The investigation of HIV and HCV infection and risk factors among opiate drug users in Beijing, China. American Journal of Drug & Alcohol Abuse 38, 140–145. - PubMed

[2] Bao Y, Du C, Lu H, Lian Z, Qiu Y, Mu Y, et al. (2012). The investigation of HIV and HCV infection and risk factors among opiate drug users in Beijing, China. American Journal of Drug & Alcohol Abuse 38, 140–145. - PubMed

[3] Bao YP, Liu ZM (2009). Systematic review of HIV and HCV infection among drug users in China. International journal of STD & AIDS 20, 399–405. - PubMed

[4] Bao YP, Liu ZM (2009). Systematic review of HIV and HCV infection among drug users in China. International journal of STD & AIDS 20, 399–405. - PubMed

[5] Degenhardt L, Charlson F, Stanaway J, Larney S, Alexander LT, Hickman M, et al. (2016). Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013. The Lancet Infectious diseases 16, 1385–1398. - PubMed

[6] Degenhardt L, Charlson F, Stanaway J, Larney S, Alexander LT, Hickman M, et al. (2016). Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013. The Lancet Infectious diseases 16, 1385–1398. - PubMed

[7] Degenhardt L, Mathers B, Vickerman P, Rhodes T, Latkin C, Hickman M (2010). Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed. Lancet (London, England) 376, 285–301. - PubMed

[8] Degenhardt L, Mathers B, Vickerman P, Rhodes T, Latkin C, Hickman M (2010). Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed. Lancet (London, England) 376, 285–301. - PubMed

[9] Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. (2017). Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global health 5, e1192–e1207. - PMC - PubMed

[10] Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. (2017). Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global health 5, e1192–e1207. - PMC - PubMed

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Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis

Affiliations

Prevalence of HIV, HCV and HBV infection and sociodemographic characteristics of people who inject drugs in China: A systematic review and meta-analysis

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical