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

Enrique R. Pouget, Holly Hagan, Don Des Jarlais

Research output: Contribution to journalArticle

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 We identified published and unpublished studies that met inclusion criteria.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% CI1.89, 3.10), filters (PRR=2.61, 95% CI1.91, 3.56), rinse water (PRR=1.98, 95% CI1.54, 2.56), combinations of this equipment (PRR=2.24, 95% CI1.28, 3.93) and 'backloading', a syringe-mediated form of sharing prepared drugs (PRR=1.86, 95% CI1.41, 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.

Original languageEnglish (US)
Pages (from-to)1057-1065
Number of pages9
JournalAddiction
Volume107
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Drug Compounding
Syringes
Hepatitis C
Meta-Analysis
Odds Ratio
Equipment and Supplies
Drug Users
Needle Sharing
Infection
Seroepidemiologic Studies
Injections
Drug Packaging
Pharmaceutical Preparations
Population
Seroconversion
Confidence Intervals
Water

Keywords

  • Hepatitis C
  • Injecting drug use
  • Meta-analysis
  • Syringe sharing

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Medicine(all)

Cite this

Meta-analysis of hepatitis C seroconversion in relation to shared syringes and drug preparation equipment. / Pouget, Enrique R.; Hagan, Holly; Des Jarlais, Don.

In: Addiction, Vol. 107, No. 6, 06.2012, p. 1057-1065.

Research output: Contribution to journalArticle

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