Home > Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013.

Degenhardt, Louisa and Charlson, Fiona and Stanaway, Jeff and Larney, Sarah and Alexander, Lily T and Hickman, Matthew and Cowie, Benjamin and Hall, Wayne and Strang, John and Whiteford, Harvey and Vos, Theo . (2016) Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013. Elsevier. The Lancet, 16 (12) DOI: http://dx.doi.org/10.1016/S1473-3099(16)30325-5

URL: http://www.thelancet.com/journals/laninf/article/P...


Background: Previous estimates of the burden of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) among people who inject drugs have not included estimates of the burden attributable to the consequences of past injecting. We aimed to provide these estimates as part of the Global Burden of Disease (GBD) Study 2013.

Methods: We modelled the burden of HBV and HCV (including cirrhosis and liver cancer burden) and HIV at the country, regional, and global level. We extracted United Nations data on the proportion of notified HIV cases by transmission route, and estimated the contribution of injecting drug use (IDU) to HBV and HCV disease burden by use of a cohort method that recalibrated individuals' history of IDU, and accumulated risk of HBV and HCV due to IDU. We estimated data on current IDU from a meta-analysis of HBV and HCV incidence among injecting drug users and country-level data on the incidence of HBV and HCV between 1990 and 2013. We calculated estimates of burden of disease through years of life lost (YLL), years of life lived with disability (YLD), deaths, and disability-adjusted life-years (DALYs), with 95% uncertainty intervals (UIs) calculated for each metric.

Findings: In 2013, an estimated 10·08 million DALYs were attributable to previous exposure to HIV, HBV, and HCV via IDU, a four-times increase since 1990. In total in 2013, IDU was estimated to cause 4·0% (2·82 million DALYs, 95% UI 2·4 million to 3·8 million) of DALYs due to HIV, 1·1% (216 000, 101 000–338 000) of DALYs due to HBV, and 39·1% (7·05 million, 5·88 million to 8·15 million) of DALYs due to HCV. IDU-attributable HIV burden was highest in low-to-middle-income countries, and IDU-attributable HCV burden was highest in high-income countries.

Item Type:Evidence resource
Publication Type:Review
Drug Type:Opioid
Intervention Type:AOD disorder, AOD disorder treatment method, AOD disorder harm reduction
Date:2016
Publisher:Elsevier
Volume:16
Number:12
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:G Health and disease > Etiology > Disease transmission factor
G Health and disease > State of health > Physical health
G Health and disease > Disorder by cause > Communicable disease
G Health and disease > Disorder by cause > Communicable disease > HIV infection
G Health and disease > Disorder by cause > Communicable disease > Hepatitis B
G Health and disease > Disorder by cause > Communicable disease > Hepatitis C
G Health and disease > Digestive system disorder > Liver disorder > Liver cirrhosis
T Demographic characteristics > Intravenous / injecting drug user
VA Geographic area > International aspects

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