title: Hepatitis C prevalence in injecting drug users in Europe, 1990-2007: impact of study recruitment setting.
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.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Rondy
authors.affiliation: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Wiessing
authors.affiliation: Health Protection Scotland, Glasgow, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Hutchinson
authors.affiliation: Academic Centre of General Practice, Katholieke Universiteit Leuven, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Matheï
authors.affiliation: ASL TO3 - Piedmont Centre for Drug Addiction Epidemiology (OED), Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mathis
authors.affiliation: National Monitoring Centre for Drugs and Drug Addiction, Czech Republic.
authors.forename: V
authors.initials: V
authors.lastname: Mravcik
authors.affiliation: Karolinska Institutet, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Norden
authors.affiliation: National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Rosińska
authors.affiliation: National Centre of Health Management, Republic of Moldova.
authors.forename: O
authors.initials: O
authors.lastname: Scutelniciuc
authors.affiliation: Istituto Superiore di Sanità, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Suligoi
authors.affiliation: Instituto de Salud Carlos III, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Vallejo
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: VAN Veen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kretzschmar
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D018671:Needle-Exchange Programs; D018579:Patient Selection; D015995:Prevalence; D012107:Research Design; D015983:Selection Bias; D016036:Seroepidemiologic Studies; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*