HIV and HCV prevalence among entrants to methadone maintenance treatment clinics in China: a systematic review and meta-analysis.
BACKGROUND
Methadone maintenance treatment (MMT) was implemented in China since 2004. It was initiated in 8 pilot clinics and subsequently expanded to 738 clinics by the end of 2011. Numerous individual research studies have been conducted to estimate HIV and HCV prevalence among MMT clients but an overview of the epidemics in relations to MMT remains unclear. The aim of this study is to estimate the magnitude and changing trends of HIV, HCV and HIV-HCV co-infections among entry clients to MMT clinics in China during 2004-2010.


METHODS
Chinese and English databases of literature were searched for studies reporting HIV, HCV and co-infection prevalence among MMT clients in China from 2004 to 2010. The prevalence estimates were summarized through a systematic review and meta-analysis of published literatures.


RESULTS
Ninety eligible articles were selected in this review (2 in English and 88 in Chinese). Nationally, pooled prevalence of HIV-HCV and HIV-HCV co-infection among MMT clients was 6.0% (95%CI: 4.7%-7.7%), 60.1% (95%CI: 52.8%-67.0%) and 4.6% (95%CI: 2.9%-7.2%), respectively. No significant temporal trend was found in pooled prevalence estimates. Study location is the major contributor of heterogeneities of both HIV and HCV prevalence among drug users in MMT.


CONCLUSIONS
There was no significant temporal trend in HIV and HCV prevalence among clients in MMT during 2004-2010. Prevalence of HCV is markedly higher than prevalence of HIV among MMT clients. It is recommended that health educational programs in China promote the earlier initiation and wider coverage of MMT among injecting drug users (IDUs), especially HIV-infected IDUs.
School of Public Health, Nantong University, Jiangsu Province, China.
Xun
X
Zhuang
Yanxian
Y
Liang
Eric P F
EP
Chow
Yafei
Y
Wang
David P
DP
Wilson
Lei
L
Zhang
D002681:China; D060085:Coinfection / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D008691:Methadone / Q000008:administration & dosage*; D058850:Opiate Substitution Treatment; D015995:Prevalence
D008691:Methadone