Objectives: To measure the incidence of hepatitis C infection in a cohort of young adult injection drug users (IDUs), and assess the multiperson use of injection paraphernalia as a predictor of incident infection.
Sample and Methods: IDUs 18-30 years old were recruited through street outreach, chain-referral, advertising from ethnically diverse neighborhoods in metropolitan Chicago between 1997-1999. Study participants were interviewed and tested for antibodies to hepatitis C virus (HCV) at baseline and two follow-ups 6 and 12 months later. Data were analyzed using standard survival statistical methods.
Results: We recruited 700 young IDUs, of whom 58% are white, 22% are Hispanic, 17% are African American and 35% are women. At baseline, median age was 23 years, half began injecting in the previous two years, and 27% tested positive for HCV. We observed 37 hepatitis C seroconversions, for an incidence rate of 12.6 per 100 person-years at risk. The adjusted relative hazard (RH) of seroconversion, after controlling for demographic and drug use covariates, was highest for sharing cookers (RH, 3.48; 95%CI,1.43-8.48), followed by sharing rinse water (RH, 2.21; 95%CI, 1.06-4.63), unbleached syringes (RH 2.04; 95%CI, 1.03-4.04), and cottons (RH, 1.96; 95%CI, 1.01-3.81). Backloading was not significantly associated with hepatitis C seroconversion.
Discussion: Young IDUs and recent injection initiates remain at high risk for hepatitis C infection. Prevention efforts should address in detail the multiple means for transmitting HCV present throughout the entire process of preparing and injecting drugs beyond the multiperson use of syringes.
Learning Objectives: At the conclusion of the presentation, the participant should have a better understanding of the multiple routes of HCV transmission present in the act of preparing and injecting drugs, and of strategies for increasing the ability of young and new injectors to prevent HCV infection
Keywords: Hepatitis C, Injecting Drug Use
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.