Matches in SemOpenAlex for { <https://semopenalex.org/work/W2754268575> ?p ?o ?g. }
- W2754268575 abstract "Background Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs Needle syringe programmes (NSP) and opioid substitution therapy (OST) are the primary interventions to reduce hepatitis C (HCV) transmission in people who inject drugs. There is good evidence for the effectiveness of NSP and OST in reducing injecting risk behaviour and increasing evidence for the effectiveness of OST and NSP in reducing HIV acquisition risk, but the evidence on the effectiveness of NSP and OST for preventing HCV acquisition is weak. Objectives To assess the effects of needle syringe programmes and opioid substitution therapy, alone or in combination, for preventing acquisition of HCV in people who inject drugs. Search methods We searched the Cochrane Drug and Alcohol Register, CENTRAL, the Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA), the NHS Economic Evaluation Database (NHSEED), MEDLINE, Embase, PsycINFO, Global Health, CINAHL, and the Web of Science up to 16 November 2015. We updated this search in March 2017, but we have not incorporated these results into the review yet. Where observational studies did not report any outcome measure, we asked authors to provide unpublished data. We searched publications of key international agencies and conference abstracts. We reviewed reference lists of all included articles and topic‐related systematic reviews for eligible papers. Selection criteria We included prospective and retrospective cohort studies, cross‐sectional surveys, case‐control studies and randomised controlled trials that measured exposure to NSP and/or OST against no intervention or a reduced exposure and reported HCV incidence as an outcome in people who inject drugs. We defined interventions as current OST (within previous 6 months), lifetime use of OST and high NSP coverage (regular attendance at an NSP or all injections covered by a new needle/syringe) or low NSP coverage (irregular attendance at an NSP or less than 100% of injections covered by a new needle/syringe) compared with no intervention or reduced exposure. Data collection and analysis We followed the standard Cochrane methodological procedures incorporating new methods for classifying risk of bias for observational studies. We described study methods against the following 'Risk of bias' domains: confounding, selection bias, measurement of interventions, departures from intervention, missing data, measurement of outcomes, selection of reported results; and we assigned a judgment (low, moderate, serious, critical, unclear) for each criterion. Main results We identified 28 studies (21 published, 7 unpublished): 13 from North America, 5 from the UK, 4 from continental Europe, 5 from Australia and 1 from China, comprising 1817 incident HCV infections and 8806.95 person‐years of follow‐up. HCV incidence ranged from 0.09 cases to 42 cases per 100 person‐years across the studies. We judged only two studies to be at moderate overall risk of bias, while 17 were at serious risk and 7 were at critical risk; for two unpublished datasets there was insufficient information to assess bias. As none of the intervention effects were generated from RCT evidence, we typically categorised quality as low. We found evidence that current OST reduces the risk of HCV acquisition by 50% (risk ratio (RR) 0.50, 95% confidence interval (CI) 0.40 to 0.63, I2 = 0%, 12 studies across all regions, N = 6361), but the quality of the evidence was low. The intervention effect remained significant in sensitivity analyses that excluded unpublished datasets and papers judged to be at critical risk of bias. We found evidence of differential impact by proportion of female participants in the sample, but not geographical region of study, the main drug used, or history of homelessness or imprisonment among study samples. Overall, we found very low‐quality evidence that high NSP coverage did not reduce risk of HCV acquisition (RR 0.79, 95% CI 0.39 to 1.61) with high heterogeneity (I2 = 77%) based on five studies from North America and Europe involving 3530 participants. After stratification by region, high NSP coverage in Europe was associated with a 76% reduction in HCV acquisition risk (RR 0.24, 95% CI 0.09 to 0.62) with less heterogeneity (I2 =0%). We found low‐quality evidence of the impact of combined high coverage of NSP and OST, from three studies involving 3241 participants, resulting in a 74% reduction in the risk of HCV acquisition (RR 0.26 95% CI 0.07 to 0.89). Authors' conclusions OST is associated with a reduction in the risk of HCV acquisition, which is strengthened in studies that assess the combination of OST and NSP. There was greater heterogeneity between studies and weaker evidence for the impact of NSP on HCV acquisition. High NSP coverage was associated with a reduction in the risk of HCV acquisition in studies in Europe." @default.
- W2754268575 created "2017-09-25" @default.
- W2754268575 creator A5000073653 @default.
- W2754268575 creator A5002599798 @default.
- W2754268575 creator A5007119843 @default.
- W2754268575 creator A5007290128 @default.
- W2754268575 creator A5036570109 @default.
- W2754268575 creator A5040409876 @default.
- W2754268575 creator A5050689894 @default.
- W2754268575 creator A5061208993 @default.
- W2754268575 creator A5061560140 @default.
- W2754268575 creator A5064327218 @default.
- W2754268575 creator A5069135365 @default.
- W2754268575 creator A5074559921 @default.
- W2754268575 creator A5083001843 @default.
- W2754268575 creator A5087774217 @default.
- W2754268575 creator A5087850879 @default.
- W2754268575 date "2017-09-18" @default.
- W2754268575 modified "2023-10-16" @default.
- W2754268575 title "Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs" @default.
- W2754268575 cites W1247968195 @default.
- W2754268575 cites W1500891868 @default.
- W2754268575 cites W1570537515 @default.
- W2754268575 cites W1589218965 @default.
- W2754268575 cites W1612443964 @default.
- W2754268575 cites W1707290380 @default.
- W2754268575 cites W1883032055 @default.
- W2754268575 cites W1886986863 @default.
- W2754268575 cites W1895949411 @default.
- W2754268575 cites W1895966687 @default.
- W2754268575 cites W1935962209 @default.
- W2754268575 cites W1966247822 @default.
- W2754268575 cites W1968966341 @default.
- W2754268575 cites W1971540772 @default.
- W2754268575 cites W1973863640 @default.
- W2754268575 cites W1974958639 @default.
- W2754268575 cites W1977300462 @default.
- W2754268575 cites W1977989660 @default.
- W2754268575 cites W1978372652 @default.
- W2754268575 cites W1981702259 @default.
- W2754268575 cites W1983036331 @default.
- W2754268575 cites W1983072592 @default.
- W2754268575 cites W1984329709 @default.
- W2754268575 cites W1988778344 @default.
- W2754268575 cites W1991140122 @default.
- W2754268575 cites W1992227982 @default.
- W2754268575 cites W1992332433 @default.
- W2754268575 cites W1995437078 @default.
- W2754268575 cites W1998162929 @default.
- W2754268575 cites W1999968120 @default.
- W2754268575 cites W2000336618 @default.
- W2754268575 cites W2003792949 @default.
- W2754268575 cites W2004653259 @default.
- W2754268575 cites W2004969769 @default.
- W2754268575 cites W2005472213 @default.
- W2754268575 cites W2008857121 @default.
- W2754268575 cites W2009781741 @default.
- W2754268575 cites W2013534419 @default.
- W2754268575 cites W2014301330 @default.
- W2754268575 cites W2014523709 @default.
- W2754268575 cites W2014938505 @default.
- W2754268575 cites W2018641128 @default.
- W2754268575 cites W2024251626 @default.
- W2754268575 cites W2024258415 @default.
- W2754268575 cites W2030028611 @default.
- W2754268575 cites W2030203976 @default.
- W2754268575 cites W2030984777 @default.
- W2754268575 cites W2031738794 @default.
- W2754268575 cites W2031965361 @default.
- W2754268575 cites W2033277750 @default.
- W2754268575 cites W2035655657 @default.
- W2754268575 cites W2037051104 @default.
- W2754268575 cites W2038073312 @default.
- W2754268575 cites W2042063943 @default.
- W2754268575 cites W2046844674 @default.
- W2754268575 cites W2047295508 @default.
- W2754268575 cites W2047569118 @default.
- W2754268575 cites W2049232480 @default.
- W2754268575 cites W2050822878 @default.
- W2754268575 cites W2051366813 @default.
- W2754268575 cites W2051831760 @default.
- W2754268575 cites W2054015394 @default.
- W2754268575 cites W2058262873 @default.
- W2754268575 cites W2058495487 @default.
- W2754268575 cites W2058678236 @default.
- W2754268575 cites W2059419882 @default.
- W2754268575 cites W2061149760 @default.
- W2754268575 cites W2061642742 @default.
- W2754268575 cites W2065686470 @default.
- W2754268575 cites W2068442101 @default.
- W2754268575 cites W2069177552 @default.
- W2754268575 cites W2073328818 @default.
- W2754268575 cites W2073438069 @default.
- W2754268575 cites W2074413674 @default.
- W2754268575 cites W2079102655 @default.
- W2754268575 cites W2081959479 @default.
- W2754268575 cites W2083768499 @default.
- W2754268575 cites W2086262590 @default.
- W2754268575 cites W2090048476 @default.
- W2754268575 cites W2090129915 @default.