High hepatitis C virus prevalence and incidence in a community cohort of young heroin injectors in a context of extensive harm reduction programmes
Por:
Vallejo, F, Barrio, G, Brugal, MT, Pulido, J, Toro, C, Sordo, L, Espelt, A, Bravo, MJ
Publicada:
1 jun 2015
Resumen:
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 <2 years was marginally associated (IRR=2.4 (95% CI 0.9 to 4.7)). HCV incidence may have been underestimated due to differential attrition.
Conclusions Despite fairly high HRI coverage among Spanish drug injectors, a distressingly high incidence of HCV in a context of high HCV prevalence was found among young heroin injectors.
Filiaciones:
Vallejo, F:
Carlos III Hlth Inst, Natl Ctr Epidemiol, Madrid, Spain
CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain
Barrio, G:
Carlos III Hlth Inst, Natl Sch Publ Hlth, Madrid, Spain
Brugal, MT:
CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain
Publ Hlth Agcy, Barcelona, Spain
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Pulido, J:
CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain
Toro, C:
Univ Hosp, La Paz Cantoblanco Carlos III, Serv Microbiol, Madrid, Spain
Sordo, L:
Carlos III Hlth Inst, Natl Ctr Epidemiol, Madrid, Spain
CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain
Espelt, A:
Publ Hlth Agcy, Barcelona, Spain
Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Psicobiol & Metodol Ciencies Salut, Bellaterra, Spain
Bravo, MJ:
Carlos III Hlth Inst, Natl Ctr Epidemiol, Madrid, Spain
CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Madrid, Spain
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