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Hepatitis C prevalence in injecting drug users in Europe, 1990–2007 : impact of study recruitment setting

Rondy, E. and Wiessing, L. and Hutchinson, Sharon and Mathei, C. and Mathis, F. and Mravcik, V. and Norden, L. and Rosiriska, M. and Scutelniciuc, O. and Suliqoi, B. and Vallejo, F. and VAN Veen, M. and Kretzschmar, M. (2013) Hepatitis C prevalence in injecting drug users in Europe, 1990–2007 : impact of study recruitment setting. Epidemiology and Infection, 141 (03). pp. 563-572. ISSN 0950-2688

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Abstract

Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P<0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6-0·8, P=0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.