Awareness of HCV in a commuinty sample of drug users in baltimore city

In the US, Hepatitis C virus (HCV) infection is the most prevalent chronic blood borne infection with an estimated 3.2 million persons being chronically infected. When paired with recent studies indicating that large proportions of HCV infected people are unaware of their disease status, the high prevalence of HCV and equally high prevalence of morbidity and mortality that occurs when the disease is undetected and untreated led the CDC to its recent recommendation that all adults born between 1945 and 1965 be tested. This recent recommendation complemented the longstanding recommendation to regularly test high risk groups such as injection drug users(IDU). The present study sought to examine (1) the prevalence of biologically confirmed HCV among a community residing sample of drug users in Baltimore City along with (2) the degree to which HCV infected adults were aware of their disease status. The findings regarding lack of HCV awareness were staggering as expected. Of the 782 drug users tested for HCV, 48% (n=376) were HCV+. However, of those infected with HCV, 63% were unaware of their positive HCV status. Factors associated with awareness of diagnosis included self reporting drug risk behaviors (OR=5.14, 95% CI 2.90-9.10, p<.001) and engaging in help seeking behaviors (OR=4.09, 95% CI 2.06-8.80, p<.001). These findings support the recommendation to routinely test high risk groups such as IDU and community residing drug users and further suggest the need to increase public awareness regarding HCV diagnosis and treatment.