Acute Hepatitis C Virus Infection in Young Adult Injection Drug Users: A Prospective Study of Incident Infection, Resolution, and Reinfection

Abstract

Background Hepatitis C virus (HCV) infection, clearance and reinfection are best studied in injection drug users (IDU) who have the highest incidence and are representative of most infections. Methods A prospective cohort of HCV negative young IDU was followed from 2000 to 2007, to identify acute and incident HCV and prospectively study infection outcomes. Results Among 1,191 young IDU screened, 731 (61.4%) were HCV negative, and 520 (71.1%) were enrolled into follow-up. Cumulative HCV incidence was 26.7 per 100 person years of observation (PYO) (95% CI, 21.5, 31.6). 95 (70.4%) of 135 acute/incident HCV infections were followed; 21% cleared HCV. Women had a significantly higher incidence of viral clearance compared to men (age-adjusted relative hazard 2.91, 95% CI, 1.68, 5.03) and also showed a significantly faster rate of early HCV viremia decline. Estimated reinfection rate was 24.6 per 100 PYO (95% CI, 11.7, 51.6). Among seven individuals, multiple episodes of HCV reinfection and re-clearance were observed. Conclusions In this large sample of young IDU, females show demonstrative differences in their rates of viral clearance and kinetics of early viral decline. Recurring reinfection and re-clearance suggest possible protection against persistent infection. These results should inform HCV clinical care and vaccine development.

Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

“…All results are shown in Table 1. The high HCV prevalence found in the IDU is in agreement with several reports from other countries regarding the risk of injection behavior for HCV infection [1,[11][12][13]. This result is not in agreement with a previous report showing the absence of HCV infection among illegal drug users in Bucaramanga, Colombia [4] and it may be associated with the low prevalence of heroin use in the studied population (3.9%).…”

Hepatitis C virus infection in children and adolescents

“…Similarly, children with comorbid conditions, such as obesity, HIV, and HBV co‐infections, cancer, and anemia, are at risk for more severe disease 4, 84. In addition, high‐risk behaviors are associated with poor outcomes of disease, including alcohol use, IVDA, homelessness, and incarceration 70, 85, 86, 87, 88…”

Characteristics and Health Service Utilization in Two Samples of Young Injection Drug Users Recruited Using Direct and Referral Methods in San Francisco, California

“…The UFO Study utilized TS methods to recruit and sample young IDU, over several waves, from 1997 to 2010; results and methods have been described in detail elsewhere [9,11]. In brief, research staff conducted street-based outreach to locate and invite prospective study subjects from neighborhoods where young IDU were known to congregate.…”

“…A true comparison would require using RDS and TS in side-by-side comparison studies with equal amount of payment or incentives and identical, if not shared, field site locations and staff, since all could influence data collection. More research must be done to truly characterize IDU populations as well as at-risk youth and young adults as they are at high risk of blood born infections and drug-related overdose [9,24]; are likely to experience symptoms of depression [25,26]; and less likely to utilize health and social services [27]. Therefore, optimizing techniques that reach and sample hidden populations, especially young IDU, where interventions are urgently needed to improve these outcomes.…”

“…The first sample is from the UFO Study, which utilized TS methods to enroll young IDU into a prospective observational cohort study of HCV risk and incidence [9]. The second sample utilized RDS to recruit IDU aged ≥ 18 years for a study conducted by the San Francisco Department of Public Health (SFDPH) as part of the National HIV Behavioral Surveillance System (NHBS IDU-2) [10].…”