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Staying hepatitis C negative: A systematic review and meta-analysis of cure and reinfection in people who inject drugs.

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Authors
Latham, Ned H
Doyle, Joseph S
Palmer, Anna Y
Vanhommerig, Joost W
Agius, Paul
Goutzamanis, Stelliana
Li, Zinia
Pedrana, Alisa
Gottfredsson, Magnus
Bouscaillou, Julie
Luhmann, Niklas
Mazhnaya, Alyona
Altice, Frederick L
Saeed, Sahar
Klein, Marina
Falade-Nwulia, Oluwaseun O
Aspinall, Esther
Hutchinson, Sharon
Hellard, Margaret E
Sacks-Davis, Rachel
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Issue Date
2019-06-10

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Citation
Latham NH, Doyle JS, Palmer AY, et al. Staying hepatitis C negative: A systematic review and meta‐analysis of cure and reinfection in people who inject drugs. Liver Int. 2019;39:2244–2260. https://doi.org/10.1111/liv.14152
Abstract
BACKGROUND AND AIMS: Direct-acting antivirals (DAAs) are highly effective in treating hepatitis C. However, there is concern that cure rates may be lower, and reinfection rates higher, among people who inject drugs. We conducted a systematic review of treatment outcomes achieved with DAAs in people who inject drugs (PWID). METHODS: A search strategy was used to identify studies that reported sustained viral response (SVR), treatment discontinuation, adherence or reinfection in recent PWID and/or opioid substitution therapy (OST) recipients. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis of proportions was used to estimate pooled SVR and treatment discontinuation rates. The pooled relative risk of achieving SVR and pooled reinfection rate were calculated using generalized mixed effects linear models. RESULTS: The search identified 8075 references; 26 were eligible for inclusion. The pooled SVR for recent PWID was 88% (95% CI, 83%-92%) and 91% (95% CI 88%-95%) for OST recipients. The relative risk of achieving SVR for recent PWID compared to non-recent PWID was 0.99 (95% CI, 0.94-1.06). The pooled treatment discontinuation was 2% (95% CI, 1%-4%) for both recent PWID and OST recipients. Amongst recent PWID, the pooled incidence of reinfection was 1.94 per 100 person years (95% CI, 0.87-4.32). In OST recipients, the incidence of reinfection was 0.55 per 100 person years (95% CI, 0.17-1.76). CONCLUSIONS: Treatment outcomes were similar in recent PWID compared to non-PWID treated with DAAs. People who report recent injecting or OST recipients should not be excluded from hepatitis C treatment.
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Additional Links
https://onlinelibrary.wiley.com/doi/full/10.1111/liv.14152
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© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ae974a485f413a2113503eed53cd6c53
10.1111/liv.14152
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English Journal Articles (Peer Reviewed)

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