Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111316

Kyle P. Openo, MPH¹, Kathy Boaz, MPH¹, C. Kirk Avent, MD², Mona Bedell, RN, MSPH³, Julia Gill, PhD, MPH⁴, Sandra Huang, MD⁵, Harriet Homan, RN⁶, Denise Stinson, RN⁷, and Ian Williams, PhD¹. (1) Division of Viral Hepatitis, NCID, Centers for Disease Control and Prevention, MS G-37, 1600 Clifton Road, Atlanta, GA 30333, 404-371-5316, keo6@cdc.gov, (2) Jefferson County Department of Health, P.O. Box 2648, 1400 Sixth Avenue South, Birmingham, AL 35202, (3) Immunization Clinic, Denver Public Health, 605 Bannock Street, Denver, CO 80204, (4) Disease Control Division, Florida Department of Health, Pinellas County Health Department, 500 7th Avenue South, St. Petersburg, FL 33701, (5) Communicable Disease Control Unit, San Francisco Department of Public Health, 101 Grove Street, San Francisco, CA 94102, (6) Multnomah County Health Department, 426 South West Stark, Portland, OR 97204, (7) Communicable Disease Control, Tacoma-Pierce County Health Department, 3629 South D Street, MS 428, Tacoma, WA 98418

Background: Injection drug use (IDU) is the primary risk factor for hepatitis C virus (HCV) infection in the United States. Understanding factors associated with infection among injectors is critical to designing appropriate prevention programs.

Methods: During 2001 to 2004, acute, symptomatic cases of hepatitis C were identified in six counties through Sentinel Surveillance. Cases were defined by an acute illness with discrete onset of symptoms; serum ALT levels >2.5 times upper limit of normal; and positive for HCV antibody or HCV RNA and negative for hepatitis A or B. Patients were extensively interviewed for risk factors for infection during the potential exposure period.

Results: A total of 111 cases were identified; 93 (83.8%) completed an interview. The most common risk factor was IDU, reported by 40 (43.0%) cases. Injectors were significantly younger than non-injectors (median 30 years vs. 39 years, respectively; p<0.001). Among injectors, 45% reported initiation of injection in the previous year; 95% reported injecting heroin (62.5%), cocaine (87.5%), or methamphetamine (67.5%). Sharing injection equipment was reported by 80%, including needles (70%) or non-syringe paraphernalia (70%). Compared with injectors who reported not sharing, injectors who shared were significantly more likely to have injected for less than one year (53.1% vs. 12.5%, p=0.04) and use heroin (75.0% vs. 12.5%, p=0.0013).

Conclusions: Almost half of injectors with acute hepatitis C reported initiating IDU in the previous year. Most injectors reported sharing injection equipment, particularly recent initiators. Hepatitis C prevention strategies should focus on preventing IDU and reducing injection-related risk behaviors.

Learning Objectives:

• List the current primary risk factor for acute hepatitis C virus (HCV) infection in the United States.
• Describe the importance of sharing of needles and non-syringe paraphernalia in the transmission of HCV among injection drug users
• Recognize the importance of hepatitis C prevention strategies which focus on prevention of injection drug use or high-risk injection behaviors, particularly in new injectors.

Keywords: Hepatitis C, Injecting Drug Use

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.