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Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews

BACKGROUND: The North American opioid crisis is marked by high opioid-related mortality and morbidity, including opioid use-associated infections (OUAIs). Users of pharmaceutical and non-pharmaceutical opioids are at an increased risk of acquiring hepatitis C (HCV), human immunodeficiency virus (HIV...

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Autores principales: Puzhko, Svetlana, Eisenberg, Mark J., Filion, Kristian B., Windle, Sarah B., Hébert-Losier, Andréa, Gore, Genevieve, Paraskevopoulos, Elena, Martel, Marc O., Kudrina, Irina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901608/
https://www.ncbi.nlm.nih.gov/pubmed/35273933
http://dx.doi.org/10.3389/fpubh.2022.749033
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author Puzhko, Svetlana
Eisenberg, Mark J.
Filion, Kristian B.
Windle, Sarah B.
Hébert-Losier, Andréa
Gore, Genevieve
Paraskevopoulos, Elena
Martel, Marc O.
Kudrina, Irina
author_facet Puzhko, Svetlana
Eisenberg, Mark J.
Filion, Kristian B.
Windle, Sarah B.
Hébert-Losier, Andréa
Gore, Genevieve
Paraskevopoulos, Elena
Martel, Marc O.
Kudrina, Irina
author_sort Puzhko, Svetlana
collection PubMed
description BACKGROUND: The North American opioid crisis is marked by high opioid-related mortality and morbidity, including opioid use-associated infections (OUAIs). Users of pharmaceutical and non-pharmaceutical opioids are at an increased risk of acquiring hepatitis C (HCV), human immunodeficiency virus (HIV), and other infections. No high-level evidence, however, has been synthesized regarding effectiveness of interventions to prevent OUAIs in legal, and illegal/mixed opioid users. The aim of the study is to synthesize available systematic review (SR)–level evidence on the scope and effectiveness of interventions to prevent OUAIs among opioid users. METHODS: A SR of SRs approach was applied. We searched PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Epistemonikos and Google Scholar from inception to September 2020. Data selection and extraction were performed independently by three researchers. Risk of bias and quality of evidence were assessed using the AMSTAR2 tool. Results were narratively synthesized. Strength of evidence for each category was reported. RESULTS: Eleven of twelve identified SRs included interventions to prevent HCV/HIV transmission in persons who inject drugs (PWID), including opioids. One SR evaluated interventions to prevent recurrent infectious endocarditis. There was sufficient and tentative SR of SRs-level evidence for the effectiveness of opioid substitution therapy (OST) in preventing HIV and HCV, respectively. We found tentative evidence to support effectiveness of needle/syringe exchange programs (NSP) in HIV prevention, and sufficient evidence to support effectiveness of the combined OST and NSP in HCV prevention. There was insufficient SR-level evidence to support or discount effectiveness of other interventions to prevent OUAIs. No SR focused on non-PWID populations. CONCLUSION: SR-level evidence supports the use of OST, NSP, and combined interventions for the reduction of HCV and HIV transmission in PWID. More research on prevention of other OUAIs and on prevention of OUAIs in non-PWID populations is urgently needed. SYSTEMATIC REVIEW REGISTRATION: Registered in PROSPERO on July 30, 2020. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195929, identifier: #195929.
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spelling pubmed-89016082022-03-09 Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews Puzhko, Svetlana Eisenberg, Mark J. Filion, Kristian B. Windle, Sarah B. Hébert-Losier, Andréa Gore, Genevieve Paraskevopoulos, Elena Martel, Marc O. Kudrina, Irina Front Public Health Public Health BACKGROUND: The North American opioid crisis is marked by high opioid-related mortality and morbidity, including opioid use-associated infections (OUAIs). Users of pharmaceutical and non-pharmaceutical opioids are at an increased risk of acquiring hepatitis C (HCV), human immunodeficiency virus (HIV), and other infections. No high-level evidence, however, has been synthesized regarding effectiveness of interventions to prevent OUAIs in legal, and illegal/mixed opioid users. The aim of the study is to synthesize available systematic review (SR)–level evidence on the scope and effectiveness of interventions to prevent OUAIs among opioid users. METHODS: A SR of SRs approach was applied. We searched PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Epistemonikos and Google Scholar from inception to September 2020. Data selection and extraction were performed independently by three researchers. Risk of bias and quality of evidence were assessed using the AMSTAR2 tool. Results were narratively synthesized. Strength of evidence for each category was reported. RESULTS: Eleven of twelve identified SRs included interventions to prevent HCV/HIV transmission in persons who inject drugs (PWID), including opioids. One SR evaluated interventions to prevent recurrent infectious endocarditis. There was sufficient and tentative SR of SRs-level evidence for the effectiveness of opioid substitution therapy (OST) in preventing HIV and HCV, respectively. We found tentative evidence to support effectiveness of needle/syringe exchange programs (NSP) in HIV prevention, and sufficient evidence to support effectiveness of the combined OST and NSP in HCV prevention. There was insufficient SR-level evidence to support or discount effectiveness of other interventions to prevent OUAIs. No SR focused on non-PWID populations. CONCLUSION: SR-level evidence supports the use of OST, NSP, and combined interventions for the reduction of HCV and HIV transmission in PWID. More research on prevention of other OUAIs and on prevention of OUAIs in non-PWID populations is urgently needed. SYSTEMATIC REVIEW REGISTRATION: Registered in PROSPERO on July 30, 2020. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195929, identifier: #195929. Frontiers Media S.A. 2022-02-22 /pmc/articles/PMC8901608/ /pubmed/35273933 http://dx.doi.org/10.3389/fpubh.2022.749033 Text en Copyright © 2022 Puzhko, Eisenberg, Filion, Windle, Hébert-Losier, Gore, Paraskevopoulos, Martel and Kudrina. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Puzhko, Svetlana
Eisenberg, Mark J.
Filion, Kristian B.
Windle, Sarah B.
Hébert-Losier, Andréa
Gore, Genevieve
Paraskevopoulos, Elena
Martel, Marc O.
Kudrina, Irina
Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title_full Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title_fullStr Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title_full_unstemmed Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title_short Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews
title_sort effectiveness of interventions for prevention of common infections among opioid users: a systematic review of systematic reviews
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901608/
https://www.ncbi.nlm.nih.gov/pubmed/35273933
http://dx.doi.org/10.3389/fpubh.2022.749033
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