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Abstract: Objective: In this paper, we review evidence of HCV prevalence among injecting drug users (IDUs) worldwide. Methods: We undertook a desk-based review of both ‘grey’ and published literature released between 1998 and 2005. Results: Data on HCV prevalence among IDUs was found in 57 countries and in 152 sub-national areas. We found reports of HCV prevalence of at least 50% among IDUs in 49 countries or territories. Available regional estimates varied widely, from 10 to 96% in Eastern Europe and Central Asia, from 10 to 100% in South and South–East Asia, from 34 to 93% in East-Asia and the Pacific, from 5 to 60% in North Africa and the Middle-East, from 2 to 100% in Latin America, from 8 to 90% in North America, from 25 to 88% in Australia and New Zealand, and from 2 to 93% in Western Europe. Only in Colombia and Lebanon were all HCV prevalence estimates below 20%. In addition, evidence of HIV/HCV co-infection among IDUs was found in 16 countries. In China, Poland, Puerto Rico, Russia, Spain, Switzerland, Thailand and Viet Nam, estimates of the prevalence of HIV/HCV co-infection among IDUs reached 90%. Discussion: Taken together, data suggest high global prevalence of HCV and HIV/HCV co-infection among IDUs. We suggest exploring protective factors in sites of low HCV prevalence. [Copyright &y& Elsevier]

Objective To describe and estimate the availability of antiretroviral treatment (ART) to injecting drug users (IDUs) in developing and transitional countries. Methods Literature review of grey and published literature and key informants’ communications on the estimated number of current/former injecting drug users (IDUs) receiving ART and the proportion of human immunodeficiency virus (HIV) attributed to injecting drug use (IDU), the number of people in ART and in need of ART, the number of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) and the main source of ART. Results Data on former/current IDUs on ART were available from 50 countries (in 19 countries: nil IDUs in treatment) suggesting that ∼34 000 IDUs were receiving ART by the end of 2004, of whom 30 000 were in Brazil. In these 50 countries IDUs represent ∼15% of the people in ART. In Eastern European and Central Asia IDU are associated with > 80% of HIV cases but only ∼2000 (14%) of the people in ART. In South and South-East Asia there were ∼1700 former/current IDUs receiving ART (∼1.8% of the people in ART), whereas the proportion of HIV cases associated to IDU is > 20% in five countries (and regionally ranges from 4% to 75%). Discussion There is evidence that the coverage of ART among current/former IDUs is proportionally substantially less than other exposure categories. Ongoing monitoring of ART by exposure and population subgroups is critical to ensuring that scale-up is equitable, and that the distribution of ART is, at the very least, transparent. [ABSTRACT FROM AUTHOR]