The HCV Synthesis Project: scope, methodology, and preliminary results.
BACKGROUND
The hepatitis C virus (HCV) is hyper-endemic in injecting drug users. There is also excess HCV among non-injection drug users who smoke, snort, or sniff heroin, cocaine, crack, or methamphetamine.


METHODS
To summarize the research literature on HCV in drug users and identify gaps in knowledge, we conducted a synthesis of the relevant research carried out between 1989 and 2006. Using rigorous search methods, we identified and extracted data from published and unpublished reports of HCV among drug users. We designed a quality assurance system to ensure accuracy and consistency in all phases of the project. We also created a set of items to assess study design quality in each of the reports we included.


RESULTS
We identified 629 reports containing HCV prevalence rates, incidence rates and/or genotype distribution among injecting or non-injecting drug user populations published between January 1989 and December 2006. The majority of reports were from Western Europe (41%), North America (26%), Asia (11%) and Australia/New Zealand (10%). We also identified reports from Eastern Europe, South America, the Middle East, and the Caribbean. The number of publications reporting HCV rates in drug users increased dramatically between 1989 and 2006 to 27-52 reports per year after 1998.


CONCLUSIONS
The data collection and quality assurance phases of the HCV Synthesis Project have been completed. Recommendations for future research on HCV in drug users have come out of our data collection phase. Future research reports can enhance their contributions to our understanding of HCV etiology by clearly defining their drug user participants with respect to type of drug and route of administration. Further, the use of standard reporting methods for risk factors would enable data to be combined across a larger set of studies; this is especially important for HCV seroconversion studies which suffer from small sample sizes and low power to examine risk factors.
Stern
Rebecca K
RK
Center for Drug Use and HIV Research, National Development and Research Institutes (NDRI), 71 West 23rd Street, 8th Floor, New York, NY 10010, USA. becca_stern73@yahoo.com
Hagan
Holly
H
Lelutiu-Weinberger
Corina
C
Des Jarlais
Don
D
Scheinmann
Roberta
R
Strauss
Shiela
S
Pouget
Enrique R
ER
Flom
Peter
P
D004812:Epidemiologic Methods; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods; D008297:Male; D010865:Pilot Projects; D012107:Research Design; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications
Am J Public Health. 2001 Jan;91(1):42-6
11189822
J Acquir Immune Defic Syndr. 2002 Jul 1;30 Suppl 1:S15-29
12107357
Am J Epidemiol. 2002 Apr 1;155(7):645-53
11914192
Subst Use Misuse. 1998 Apr;33(5):1197-212
9596383
JAMA. 2000 Apr 19;283(15):2008-12
10789670
J Acquir Immune Defic Syndr. 2004 Jun 1;36(2):743-9
15167294
NIDA Res Monogr. 1991;109:75-100
1661376
Am J Epidemiol. 1999 Feb 1;149(3):203-13
9927214
J Psychoactive Drugs. 2003 Oct-Dec;35(4):455-60
14986874
Scand J Infect Dis. 2001;33(6):457-61
11450866
CMAJ. 2001 Oct 2;165(7):889-95
11599327
J Viral Hepat. 2002 May;9(3):157-73
12010503
J Hepatol. 2006;44(1 Suppl):S25-7
16338020
Drug Alcohol Depend. 2005 Sep 1;79(3):389-95
16102381
AIDS. 2005 Oct;19 Suppl 3:S199-207
16251818
BMJ. 1998 Jan 10;316(7125):140-4
9462324
Subst Use Misuse. 2002 Mar;37(4):573-5
12064440
Medicine (Baltimore). 1995 Jul;74(4):212-20
7623656
Subst Use Misuse. 2001 Mar;36(4):523-34
11346280
Hepatology. 2001 Jul;34(1):180-7
11431749
Epidemiol Infect. 2002 Dec;129(3):577-85
12558341
Hepatology. 2002 Sep;36(3):737-42
12198668
BMJ. 1998 Aug 15;317(7156):433-7
9703523
Drug Alcohol Depend. 2007 Jun 15;89(1):1-12
17174481
AIDS. 2005 Oct;19 Suppl 3:S20-5
16251819
Hepatology. 2002 Nov;36(5 Suppl 1):S210-9
12407596
Am J Epidemiol. 2003 Mar 1;157(5):467-71
12615611
AIDS. 2006 Jan 2;20(1):111-6
16327326
Am J Public Health. 2001 Jan;91(1):38-42
11189821
Int J Drug Policy. 2007 Oct;18(5):341-51
17854721