FINDINGS OF THIS STUDY What is known? People who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. What is new? This study reviews the literature on a range of indicators on HCV in PWID in Europe, complementing routine monitoring by the EMCDDA, to guide HCV treatment policies. It shows that data are of variable quality and in some areas scarce, however, diagnosis and treatment rates of PWID remain poor across the EU. Interpretation Key data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID. HOW DOES THIS STUDY ANSWER THE QUESTIONS OF THIS THESIS? How can monitoring be improved? Monitoring systems should consider filling existing gaps in evidence with regard to HCV diagnosis and treatment uptake of PWID. Systematic reviews of the literature are an important complement to routine monitoring in order to assess the evidence available to guide policy making. Routine monitoring should be regularly enhanced with all other available evidence. What is the spread of HIV and HCV among PWID? HCV incidence data are scarce and often not recent, but where available they suggest high levels of new infections among PWID. HIV coinfection among HCV infected PWID is highly variable and reflects the epidemiology of HIV among PWID in the EU. What are the implications for prevention? This study shows that, although data are scarce and often not of good quality, where data are available in the EU, the rates of diagnosis among PWID, and of treatment uptake among those diagnosed, are low.
FINDINGS OF THIS STUDY What is known? People who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. What is new? This study reviews the literature on a range of indicators on HCV in PWID in Europe, complementing routine monitoring by the EMCDDA, to guide HCV treatment policies. It shows that data are of variable quality and in some areas scarce, however, diagnosis and treatment rates of PWID remain poor across the EU. Interpretation Key data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID. HOW DOES THIS STUDY ANSWER THE QUESTIONS OF THIS THESIS? How can monitoring be improved? Monitoring systems should consider filling existing gaps in evidence with regard to HCV diagnosis and treatment uptake of PWID. Systematic reviews of the literature are an important complement to routine monitoring in order to assess the evidence available to guide policy making. Routine monitoring should be regularly enhanced with all other available evidence. What is the spread of HIV and HCV among PWID? HCV incidence data are scarce and often not recent, but where available they suggest high levels of new infections among PWID. HIV coinfection among HCV infected PWID is highly variable and reflects the epidemiology of HIV among PWID in the EU. What are the implications for prevention? This study shows that, although data are scarce and often not of good quality, where data are available in the EU, the rates of diagnosis among PWID, and of treatment uptake among those diagnosed, are low.
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