A systematic review and meta-analysis of interventions to prevent hepatitis C virus infection in people who inject drugs

J Infect Dis. 2011 Jul 1;204(1):74-83. doi: 10.1093/infdis/jir196.


Introduction: High rates of hepatitis C virus (HCV) transmission are found in samples of people who inject drugs (PWID) throughout the world. The objective of this paper was to meta-analyze the effects of risk-reduction interventions on HCV seroconversion and identify the most effective intervention types.

Methods: We performed a systematic review and meta-analysis of published and unpublished studies. Eligible studies reported on the association between participation in interventions intended to reduce unsafe drug injection and HCV seroconversion in samples of PWID.

Results: The meta-analysis included 26 eligible studies of behavioral interventions, substance-use treatment, syringe access, syringe disinfection, and multicomponent interventions. Interventions using multiple combined strategies reduced risk of seroconversion by 75% (pooled relative risk, .25; 95% confidence interval, .07-.83). Effects of single-method interventions ranged from .6 to 1.6.

Conclusions: Interventions using strategies that combined substance-use treatment and support for safe injection were most effective at reducing HCV seroconversion. Determining the effective dose and combination of interventions for specific subgroups of PWID is a research priority. However, our meta-analysis shows that HCV infection can be prevented in PWID.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Behavior Therapy
  • Communicable Disease Control / methods*
  • Disease Transmission, Infectious / prevention & control*
  • Hepatitis C / prevention & control*
  • Hepatitis C / transmission
  • Humans
  • Substance Abuse, Intravenous / complications*
  • Treatment Outcome