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Hepatitis C seroprevalence amongst injecting drug users attending a methadone programme
J Chetwynd1, C Brunton, M Blank
1Department of Public Health and General Practice, Christchurch School of Medicine.
Insights
Hepatitis C virus (HCV) infection is highly prevalent in injecting drug users, with infection risk increasing with longer drug use and equipment sharing. Continued transmission highlights the need for prevention strategies.
Area of Science:
- Virology
- Public Health
- Epidemiology
Background:
- Hepatitis C virus (HCV) poses a significant health burden globally.
- Injecting drug users (IDUs) are a key population for HCV transmission and prevalence.
- Understanding risk factors is crucial for targeted prevention interventions.
Purpose of the Study:
- To determine the seroprevalence of Hepatitis C virus (HCV) in a cohort of injecting drug users.
- To investigate the association between potential risk factors and HCV infection within this population.
Main Methods:
- A study was conducted with 116 clients at a methadone treatment clinic.
- Blood samples were analyzed for HCV antibodies and RNA, with serum transaminases measured.
- Participants completed a confidential questionnaire on sexual behavior and drug use practices.
Main Results:
- HCV antibodies were detected in 84.2% and HCV RNA in 66.1% of participants.
- Seroprevalence increased with duration of injecting drug use and sharing of injecting equipment.
- While sharing of equipment has decreased, HCV transmission persists.
Conclusions:
- HCV is widespread among injecting drug users, indicating a substantial clinical and social issue.
- Ongoing HCV transmission necessitates vigilance for other parenterally transmitted infections like HIV.
- Individuals at high risk for HCV should be advised against blood donation due to seronegative infectivity risk.
Aim:
To study the seroprevalence of the hepatitis C virus (HCV) amongst a population of injecting drug users and to examine the relationship between potential risk factors and HCV infection.
Methods:
A sample of 116 clients attending a methadone treatment clinic in Christchurch took part in this study. Blood samples were analysed to detect antibodies to HCV and to test for HCV RNA: Serum transaminases were also measured. In addition a short questionnaire about sexual behaviour and drug use practices was self completed by all participants in strictest confidence.
Results:
Slightly more than half the sample were female (54.3%) and most were of European origin (90.6%). The average age was 31.56 years and the average length of time they had been injecting drugs was 9.54 years. HCV antibodies were detected in 84.2% of the sample and HCV RNA in 66.1% of the sample including 75.9% amongst those who were anti-HCV positive and 16.6% amongst those who were anti-HCV negative. AST and ALT levels were elevated amongst 16.8% and 46.2% of the sample respectively. The likelihood of being anti-HCV positive increased with years of drug use and with increased sharing of injecting equipment. No significant relationship between HCV status and sexual practices was evident. Data on the history of drug using practices indicated that sharing of injecting equipment had become less common over time and access to new equipment through reliable sources had become more common with time.
Conclusions:
HCV is widespread amongst this population of injecting drug users suggesting the possibility of a major clinical and social problem. Despite evidence of a reduction in the sharing of injecting equipment, HCV transmission is still occurring indicating the potential for other parenterally transmitted diseases, such as HIV, to become established amongst injecting drug users. Those at high risk of HCV should be discouraged from donating blood because of the possibility of HCV seronegative infectivity.
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