Evidence map›Paper›PMID 36996853›Full record

SynthesisThe lancet. Gastroenterology & hepatology2023

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.

Adelina Artenie, Jack Stone, Hannah Fraser, Daniel Stewart, Chiedozie Arum, Aaron G Lim, Anna L McNaughton, Adam Trickey, Zoe Ward, Daniela Abramovitz and 23 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The lancet. Gastroenterology & hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 3 pooled it
18.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  9. Potential Impact of Frequent Testing for Hepatitis C Virus Among People Who Inject Drugs Toward Hepatitis C Elimination in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
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  19. Liver disease in people living with HIV infection: a changing landscape.Nature reviews. Gastroenterology & hepatology · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

33 authors at 9 institutions in 5 countries.

Adelina ArteniePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK. Electronic address: adelina.artenie@bristol.ac.uk.
Jack StonePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Hannah FraserPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Daniel StewartPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Public Health Speciality Training Programme, South West, Bristol, UK.
Chiedozie ArumYale School of Medicine, Yale University, New Haven, CT, USA.
Aaron G LimPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Anna L McNaughtonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Adam TrickeyPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Zoe WardPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Daniela AbramovitzSchool of Medicine, University of California, San Diego, CA, USA.
Michel AlaryCentre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada; Département de médecine sociale et préventive, Université Laval, Québec City, QC, Canada; Institut national de santé publique du Québec, Québec City, QC, Canada.
Jacquie AstemborskiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Julie BruneauDépartement de Médecine Familiale et Médecine d'Urgence, Université de Montréal, Montréal, QC, Canada; Centre Hospitalier de l'Université de Montréal Research Center, Montréal, QC, Canada.
Steven J ClipmanDepartment of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Carla S CoffinCumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Sara CroxfordPublic Health and Clinical Directorate, UK Health Security Agency, London, UK.
Kora DeBeckSchool of Public Policy, Simon Fraser University, Vancouver, BC, Canada; BC Centre on Substance Use, Vancouver, BC, Canada.
Eva EmanuelBlood Safety, Hepatitis, STI and HIV Division, UK Health Security Agency, London, UK.
Kanna HayashiBC Centre on Substance Use, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Joumana G HermezDepartment of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Daniel Low-BeerGlobal HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland.
Niklas LuhmannGlobal HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland.
Gisela MacphailCumming School of Medicine, University of Calgary, Calgary, AB, Canada; Infectious Diseases, CUPS Liver Clinic, Calgary, AB, Canada.
Lisa MaherKirby Institute for Infection and Immunity, UNSW Sydney, Sydney, NSW, Australia.
Norah E PalmateerSchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Public Health Scotland, Glasgow, UK.
Eshan U PatelDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Rachel Sacks-DavisDisease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Wijnand Van Den BoomDisease Elimination Program, Burnet Institute, Melbourne, VIC, Australia.
Daniela K van SantenDisease Elimination Program, Burnet Institute, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands.
Josephine G WalkerPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Matthew HickmanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
Peter VickermanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
HIV and HCV Incidence Review Collaborative Group
Johns Hopkins University · USUK Health Security AgencyWorld Health Organization · CHBurnet Institute · AUUniversity of Bristol · GBUniversity of Calgary · CAUniversity of California, San Diego · USUNSW Sydney · AUYale University · US

Funding

Vancouver Drug Users Study: The Impacts of Evolving Drug Use Patterns on HIV/AIDSU01DA038886 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI DEBECK, KORA, HAYASHI, KANNA · 2015 to 2024
$12.1M
Increasing Access to Hepatitis C Treatment in Opioid Endemic Rural Areas: the Kentucky Viral Hepatitis Treatment (KeY Treat) StudyR01DA047952 · NIDA · UNIVERSITY OF KENTUCKY · PI HAVENS, JENNIFER R · 2018 to 2023
$8.7M
Expanding Medication Assisted Therapy in Ukraine (ExMAT)R01DA033679 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2012 to 2021
$6.4M
Individual, Network and Spatial Drivers of HIV and HCV among PWID in IndiaR01DA041736 · NIDA · JOHNS HOPKINS UNIVERSITY · PI SOLOMON, SUNIL SUHAS · 2016 to 2021
$5.0M
Molecular Networks and Deep Learning for Targeted HIV Interventions among PWIDDP2DA056130 · NIDA · JOHNS HOPKINS UNIVERSITY · PI CLIPMAN, STEVEN J. · 2022 to 2022
$2.5M
Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modelingR01AI147490 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA · 2019 to 2022
$2.3M
Modeling Structural HIV Determinants in Substance Users and related populationsR01DA037773 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA, STRATHDEE, STEFFANIE A. · 2015 to 2017
$1.4M
Informing hepatitis C virus elimination strategies with epidemiological data from highest need populationsR21DA046809 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MORRIS, MEGHAN D · 2019 to 2020
$385k
Department of HealthMedical Research Council MC_UU_00004/03Medical Research Council MR/N00616X/1NIAID NIH HHS R01 AI147490NIDA NIH HHS DP2 DA056130NIDA NIH HHS L60 DA056996NIDA NIH HHS R01 DA033679NIDA NIH HHS R01 DA037773NIDA NIH HHS R01 DA041736NIDA NIH HHS R01 DA047952NIDA NIH HHS R21 DA046809NIDA NIH HHS U01 DA038886Wellcome TrustWorld Health Organization 001
6 · The paper itself

Abstract

backgroundMeasuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to summarise global data on HIV and primary HCV incidence among PWID and associations with age and sex or gender.

methodsIn this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies among PWID by searching MEDLINE, Embase, and PsycINFO, capturing studies published between Jan 1, 2000, and Dec 12, 2022, with no language or study design restrictions. We contacted authors of identified studies for unpublished or updated data. We included studies that estimated incidence by longitudinally re-testing people at risk of infection or by using assays for recent infection. We pooled incidence and relative risk (RR; young [generally defined as ≤25 years] vs older PWID; women vs men) estimates using random-effects meta-analysis and assessed risk of bias with a modified Newcastle-Ottawa scale. This study is registered with PROSPERO, CRD42020220884.

findingsOur updated search identified 9493 publications, of which 211 were eligible for full-text review. An additional 377 full-text records from our existing database and five records identified through cross-referencing were assessed. Including 28 unpublished records, 125 records met the inclusion criteria. We identified 64 estimates of HIV incidence (30 from high-income countries [HICs] and 34 from low-income or middle-income countries [LMICs]) and 66 estimates of HCV incidence (52 from HICs and 14 from LMICs). 41 (64%) of 64 HIV and 42 (64%) of 66 HCV estimates were from single cities rather than being multi-city or nationwide. Estimates were measured over 1987-2021 for HIV and 1992-2021 for HCV. Pooled HIV incidence was 1·7 per 100 person-years (95% CI 1·3-2·3; I

interpretationAlthough sparse, available HIV and HCV incidence estimates offer insights into global levels of HIV and HCV transmission among PWID. Intensified efforts are needed to keep track of the HIV and HCV epidemics among PWID and to expand access to age-appropriate and gender-appropriate prevention services that serve young PWID and women who inject drugs.

fundingCanadian Institutes of Health Research, Fonds de recherche du Québec-Santé, Canadian Network on Hepatitis C, UK National Institute for Health and Care Research, and WHO.

Indexed as

Drug UsersHepatitis CHIV InfectionsSubstance Abuse, IntravenousCanadaFemaleHepacivirusHumansIncidenceMale

Identifiers

PMID36996853
PMCPMC10817215
OpenAlexW4360991486

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.