High hepatitis C virus prevalence and incidence in a community cohort of young heroin injectors in a context of extensive harm reduction programmes

Background Cohort studies on hepatitis C virus (HCV) among drug injectors are scarcer than studies on HIV. Combined harm reduction interventions (HRIs) can prevent HCV infection. Spain has a medium–high coverage of HRIs. Methods 513 young heroin users who injected drugs in the past 12 months (recent...

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Bibliographic Details
Published in:Journal of epidemiology and community health (1979) 2015-06, Vol.69 (6), p.599-603
Main Authors: Vallejo, Fernando, Barrio, Gregorio, Brugal, M Teresa, Pulido, Jose, Toro, Carlos, Sordo, Luis, Espelt, Albert, Bravo, María J
Format: Article
Language:English
Subjects:
Adult
Behavior
Bias
Comorbidity
Drug Users - statistics & numerical data
Female
Harm Reduction
Health risk assessment
Hepacivirus - isolation & purification
Hepatitis
Hepatitis C - epidemiology
Hepatitis C - prevention & control
Hepatitis C - transmission
Hepatitis C virus
Heroin
Heroin Dependence - complications
Heroin Dependence - epidemiology
Heroin Dependence - rehabilitation
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Incidence
Infections
Interviews
Male
Needle-Exchange Programs
Opiate Substitution Treatment
Prevalence
Prevention
Seroconversion
Sexual Behavior
Sexually transmitted diseases
Short reports
Spain - epidemiology
STD
Studies
Substance Abuse, Intravenous - complications
Substance Abuse, Intravenous - epidemiology
Substance Abuse, Intravenous - rehabilitation
Young Adult
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Summary:Background Cohort studies on hepatitis C virus (HCV) among drug injectors are scarcer than studies on HIV. Combined harm reduction interventions (HRIs) can prevent HCV infection. Spain has a medium–high coverage of HRIs. Methods 513 young heroin users who injected drugs in the past 12 months (recent injectors) were street-recruited in 2001–2003 and followed until 2006 in three Spanish cities; 137 were anti-HCV seronegative, 77 of whom had ≥1 follow-up visit. Dried blood spots were tested for anti-HCV. HCV incidence and predictors of infection were estimated using Poisson models. Results At baseline, 73% were anti-HCV positive. Overall incidence (n=77) of HCV seroconversion was 39.8/100 person-years (py) (95% CI 28.7 to 53.8). Excluding non-injectors during follow-up from the analysis (n=57), HCV incidence was 52.9/100 py (95% CI 37.4 to 72.5). Injecting at least weekly (incidence rate ratio (IRR)=5.2 (95% CI 2.5 to 11.1)) and having ≥2 sexual partners (IRR=2.2 (95% CI 1.1 to 4.7)) were independent predictors of HCV seroconversion; drug-injection history
ISSN:0143-005X
1470-2738
DOI:10.1136/jech-2014-205070