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HCV among Socioeconomically Marginalized Populations
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HCV among Socioeconomically Marginalized Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 3197

Special Issue Editor

Dr. Matthew J. Akiyama

E-Mail Website
Guest Editor
Albert Einstein College of Medicine, 3300 Kossuth Ave, Bronx, NY 10467, USA
Interests: HCV treatment and prevention strategies with particular emphasis on the relationship between HCV, substance use, and the criminal justice system in the US and sub-Saharan Africa

Special Issue Information

Dear colleagues,

Hepatitis C virus (HCV) is a global pandemic with an estimated 71 million individuals infected worldwide. In recent years, highly effective, well tolerated, all oral direct-acting antiviral (DAA) therapies for HCV have raised hope for an era in which HCV elimination is achievable worldwide. In 2016, the World Health Organization issued viral hepatitis elimination targets that include diagnosing 90% of individuals living with HCV, initiating 80% of those who are eligible on treatment, and reducing incidence by 90%. These ambitious targets are still far from being realized, with only twelve countries currently on track to achieve HCV elimination by 2030.

HCV is a blood-borne pathogen, and, due to its long life span on inanimate surfaces, transmission occurs predominantly through injection drug use and healthcare exposure in settings where screening of blood products and sterilization are limited. Consequently, HCV disproportionately affects socioeconomically marginalized populations, such as people who use drugs (PWID) and individuals in low- and middle-income countries. Higher rates of homelessness, incarceration, mental illness, and other conditions that are syndemic with poverty are also observed more frequently among people living with HCV. 

In this Special Issue of International Journal of Environmental Research and Public Health (IJERPH), we are inviting prospective longitudinal designs, random controlled trials, meta-analyses, innovative technologies (such as point of care testing and phylogenetic analysis), and the application of these methods and technologies in socioeconomically marginalized populations. Papers addressing these topics are invited for this Special Issue, especially those combining a high academic standard coupled with a practical focus on providing optimal solutions for HCV elimination among socioeconomically marginalized populations.

Dr. Matthew J. Akiyama
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HCV
  • Hepatitis C
  • DAA
  • PWID
  • IDU
  • Epidemiology
  • Elimination
  • Socioeconomic status
  • Health inequality

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Published Papers (1 paper)

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Review

11 pages, 475 KiB  
Review
Hepatitis C Reinfection in People Who Inject Drugs in Resource-Limited Countries: A Systematic Review and Analysis
by Abbe Muller, David Vlahov, Matthew J. Akiyama and Ann Kurth
Int. J. Environ. Res. Public Health 2020, 17(14), 4951; https://doi.org/10.3390/ijerph17144951 - 9 Jul 2020
Cited by 13 | Viewed by 2955
Abstract
Hepatitis C (HCV) is a global pandemic. The World Health Organization has developed a strategic plan for HCV elimination that focuses on low- and middle-income countries (LMICs) and high-risk populations, including people who inject drugs (PWID). While direct-acting antiviral (DAA) therapies are highly [...] Read more.
Hepatitis C (HCV) is a global pandemic. The World Health Organization has developed a strategic plan for HCV elimination that focuses on low- and middle-income countries (LMICs) and high-risk populations, including people who inject drugs (PWID). While direct-acting antiviral (DAA) therapies are highly effective at eliminating HCV infections and have few side effects, medical professionals and policymakers remain concerned about the risk of reinfection among PWID. This study is a systematic review of research measuring the rate of HCV reinfection among PWID in LMICs and identifies additional areas for further research. A systematic search strategy was used to identify studies documenting HCV reinfection after sustained virologic response in PWID in LMICs. We refined results to include studies where at least 50% of participants had DAA treatment for primary HCV infection. Pooled reinfection rate was calculated across all studies. Seven studies met eligibility criteria. Most studies were conducted in six upper middle-income countries (Mexico, Romania, Russia, Taiwan, Georgi, and Brazil) and one lower middle-income country (Bangladesh) with a total of 7665 participants. No study included information from PWID in low-income countries. Sample sizes ranged from 200 to 3004 individuals, with demographic data missing for most participants. Four studies used deep gene sequencing, and reflex genotyping procedures to differentiate reinfection (infection by a different HCV genotype/subtype) from virologic relapse (infection by the same strain). The follow-up time of people cured from primary chronic HCV infection ranged from 12 weeks to 6.6 years. The pooled reinfection rate of all seven studies was 2.8 (range: 0.02 to 10.5) cases per 100 person-years (PY). In the five studies that differentiated relapse from reinfection, the incidence of reinfection was 1.0 per 100 PY. To date, research on reinfection rates among PWID in LMICs remains limited. Research focused on PWID in low-income countries is particularly needed to inform clinical decision making and evidence-based programs. While rates of reinfection among PWID who complete DAA treatment in upper and lower middle-income countries were similar or lower than rates observed in PWID in high-income countries, the rates were highly variable and factors may influence the accuracy of these measurements. This systematic review identifies several areas for continued research. Policies concerning access to HCV testing and treatment should be comprehensive and not place restrictions on PWID in these settings. Full article
(This article belongs to the Special Issue HCV among Socioeconomically Marginalized Populations)
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