Success Metrics for Hepatitis C Elimination Among People Who Inject Drugs: A Scoping Review of Indicators in Harm Reduction

TL;DR

This study reviews which metrics are used to track hepatitis C elimination among drug users, finding that prevalence and incidence are most commonly reported, while other important indicators are often ignored.

Contribution

The study identifies a gap in the use of diverse and standardized success metrics for hepatitis C elimination in harm reduction programs targeting people who inject drugs.

Findings

Prevalence and incidence are the most frequently reported indicators for hepatitis C among people who inject drugs.

Screening, treatment uptake, and treatment completion are rarely reported in systematic reviews.

Inconsistent measurement approaches and a lack of standardized frameworks were observed across all indicators.

Abstract

This study aimed to identify and synthesize the success metrics used to assess hepatitis C elimination among people who inject drugs (PWID) through harm reduction strategies. A scoping review was performed by searching across three databases to identify systematic reviews that discussed hepatitis C in PWID within the context of harm reduction. The studies were then analyzed for success metrics used to describe hepatitis C in PWID. The indicators used were prevalence, incidence, screening, treatment uptake, treatment completion, and sustained virologic response. A total of fourteen systematic reviews were included. The most frequently reported indicators were prevalence and incidence, addressed in eight/seven systematic reviews, respectively. In contrast, screening, treatment uptake, and treatment completion were less commonly reported, with only two reviews addressing screening and treatment uptake, and a single review reporting treatment completion. Similarly, sustained virologic response (SVR) was reported in only two systematic reviews. Seven additional indicators were reported. Prevalence and incidence are the dominantly used HCV indicators, while others are often neglected. Inconsistencies in measurements and reporting can be found for all indicators. This study reports a gap regarding indicators beyond prevalence and incidence, inconsistent measurement approaches, and a lack of standardized frameworks.

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