Using Hepatitis C Prevalence to Estimate HIV Epidemic Potential among People Who Inject Drugs in the Middle East & North Africa

The objective of this study is to understand the association between HIV and hepatitis C virus (HCV) among people who inject drugs (PWIDs) in the Middle East and North Africa (MENA), and to estimate HIV epidemic potential among PWIDs using HCV prevalence...

The review identified 88 HCV prevalence measures among PWID in MENA, of which 54 had a paired HIV prevalence measure. The pooled RR_HCV/HIV were 16, 4 and 3 in low-level, emerging and established HIV epidemics, respectively. There was a significant linear relationship between HCV and HIV at endemic equilibrium. The predicted endemic HIV prevalence ranged between 8% (Tunisia) and 22% (Pakistan). Of the nine countries with data, five have high and three medium HIV epidemic potential. Only one country, Pakistan, appears to have reached saturation.

HCV prevalence could be a predictor of future endemic HIV prevalence. In MENA, we predict that there will be further HIV epidemic growth among PWID. The proposed methodology can identify PWID populations that should be prioritized for HIV prevention interventions.

Below:  Mathematical modelling simulation of an HIV epidemic expansion among a prototype PWID population. (a) A case scenario for an HIV epidemic expansion in a PWID population wherein HCV is endemic at a prevalence level of about 75% indicating high injecting risk behaviour. HIV is introduced in 1990, starts emerging with increasing prevalence about two decades later in the late 1990s, and saturates near the year 2020 at a prevalence of about 20%. The corresponding three HIV epidemic states – low level, emerging and established – are shown on the graph. (b) The risk ratio of HCV to HIV prevalence (RRHCV/HIV) among this PWID population.

Read more at: http://ht.ly/Spnrs 

By: Ghina R. Mumtaz,a,b Helen A. Weiss,b Peter Vickerman,c Natasha Larke,b and Laith J. Abu-Raddada,d,e

^bMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London

^cSchool of Social and Community Medicine, University of Bristol, Bristol, UK

^dDepartment of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, Ithaca, New York

^e

aInfectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar

bMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London

cSchool of Social and Community Medicine, University of Bristol, Bristol, UK

dDepartment of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, Ithaca, New York

eVaccine and Infectious Disease Institute, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

More at:  

https://twitter.com/hiv_insight
http://twitter.com/Prison_Health

aInfectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar