title: High hepatitis C virus prevalence among drug users in Iran: systematic review and meta-analysis of epidemiological evidence (2001-2012).
abstract: OBJECTIVE
  Drug users, particularly drug injectors, are at elevated risk of blood-borne diseases. This study systematically reviewed the prevalence of hepatitis C virus (HCV) mono-infection and its co-infections with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in drug users in Iran.
  
  
  METHODS
  Searches were conducted in international, regional, and Iranian databases. Documents were screened, data extracted, and pooled point prevalence and 95% confidence intervals (CI) were calculated.
  
  
  RESULTS
  Overall, 13,821 subjects (87.4% male) with an average age of 32.4 years (95% CI 31-33 years) from 24 original studies were included in the analysis. The pooled HCV prevalence (95% CI) among drug users with and without an injection history was 45% (37-54%) and 8% (4-13%), respectively. The pooled HCV prevalences (95% CI) among individuals with vs. without a history of imprisonment and needle sharing were 58% (39-77%) vs. 44% (20-68%) and 56% (41-71%) vs. 49% (26-71%), respectively. The prevalence of HCV/HIV co-infection among injectors was 11% (95% CI 5-16%).
  
  
  CONCLUSIONS
  HCV prevalence is high in drug users in Iran, especially among those with a history of injection drug use, needle sharing, and imprisonment. Drug user-focused HCV prevention and treatment programs are urgently needed.
authors.affiliation: Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA; Global Health Sciences, University of California, 3333 California Street, Suite 265, San Francisco, CA 94118, USA. Electronic address: MMalekinejad@ucsf.edu.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Malekinejad
authors.affiliation: Global Health Sciences, University of California, 3333 California Street, Suite 265, San Francisco, CA 94118, USA; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Navadeh
authors.affiliation: Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Lotfizadeh
authors.affiliation: Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Afarin
authors.initials: A
authors.lastname: Rahimi-Movaghar
authors.affiliation: Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Amin-Esmaeili
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Noroozi
mesh_terms: D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology*
keywords: Drug use; HIV; Harm reduction; Hepatitis B; Hepatitis C; Iran