Incidence and prevalence of hepatitis c virus infection among persons who inject drugs in New York City: 2006–2013

Abstract

Background Hepatitis C virus infection is a source of significant preventable morbidity and mortality among persons who inject drugs (PWID). We sought to assess trends in hepatitis C virus (HCV) infection among PWID from 2006 – 2013 in New York City (NYC). Methods Annual cross-sectional surveys of PWID entering a large drug abuse treatment program were performed. Risk behavior questionnaires were administered, and HIV and HCV testing were conducted. Comparisons were made with prior prevalence and incidence estimates in 1990 – 1991 and 2000 – 2001 reflecting different periods of combined prevention and treatment efforts. Results HCV prevalence among PWID (N: 1,535) was 67% (95% CI: 66-70%) during the study period, and was not significantly different from that observed in 2000 – 2001. The estimated HCV incidence among new injectors (persons injecting for <= 6 years) during 2006 – 2013 was 19.5/100 PYO (95% CI: 17-23) and did not differ from that observed in 2000 – 2001 (18/100 PYO, 95% CI: 14-23/100). Conclusions Despite the expansion of combined prevention programming between 2000 – 2001 and 2006 – 2013, HCV prevalence remained high. Estimated HCV incidence among new injectors also remained high, and not significantly lower than in 2000 – 2001, indicating that expanded combined prevention efforts are needed to control the HCV epidemic among PWID in NYC.

Outcomes of Patients in Long-Term Opioid Maintenance Treatment

“…The rate of HCV infected patients did not markedly differ from the 50-90% typically found in i.v. drug users or OMT patients (EMCDDA, 2012;Jordan et al, 2015). This could partly be explained by the fact that HCV infection rates are already high in younger (< 25 years) and in newly (< 2 years) injecting drug users (EMCDDA 2012).…”

HIV Prevalence, Estimated Incidence, and Risk Behaviors Among People Who Inject Drugs in Kenya

“…39 These methods have been used in other recent studies. 40,41 Two opposing factors were considered when deciding which PWID to include in estimates of incidence. Including PWID with more years injecting increases sample size and allows for examination of a key assumption.…”

HCV reinfection incidence among individuals treated for recent infection

“…Reinfection was associated with injection drug use following treatment and older age, the latter appearing to be related to older age and shorter time since injecting onset among PWID with reinfection. Recent onset of injection drug use has been associated with HCV acquisition, though typically among young PWID . The increased risk of reinfection seen with injection drug use post‐treatment in association with use of unsterile needles and syringes highlights the need for education and broad access to harm reduction and prevention strategies in concert with HCV treatment.…”