Retrospective cohort study examining incidence of HIV and hepatitis C infection among injecting drug users in Dublin

Smyth, Bobby P; O’Connor, John; Barry, Joseph; Keenan, Eamon

doi:10.1136/jech.57.4.310

Cited by 32 publications

(31 citation statements)

References 6 publications

(8 reference statements)

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“…Younger age is a recognized risk factor for increased HCV incidence among IDUs (van Beek, Dwyer, Dore, Luo, & Kaldor, 1998). Although our sample size is very small, our finding compares favorably with an earlier Dublin study that reported an HCV incidence among IDUs of 66 infections per 100 PYAR in the 1990s (Smyth, O'Connor, Barry, & Keenan, 2003).…”

Section: Blood-borne Viral Infection Outcomessupporting

confidence: 85%

Outcome of heroin-dependent adolescents presenting for opiate substitution treatment

Smyth

Fagan²,

Kernan³

2012

Journal of Substance Abuse Treatment

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Because the outcome of methadone and buprenorphine substitution treatment in adolescents is unclear, we completed a retrospective cohort study of 100 consecutive heroin-dependent adolescents who sought these treatments over an 8-year recruitment period. The participants' average age was 16.6 years, and 54 were female. Half of the patient group remained in treatment for over 1 year. Among those still in treatment at 12 months, 39% demonstrated abstinence from heroin. The final route of departure from the treatment program was via planned detox for 22%, dropout for 32%, and imprisonment for 8%. The remaining 39% were transferred elsewhere for ongoing opiate substitution treatment after a median period of 23 months of treatment. Males were more likely to exit via imprisonment (p < .05), but other outcomes were not predicted by gender. There were no deaths during treatment among these 100 patients who had a cumulative period of 129 person years at risk. Our findings suggest that this treatment delivers reductions in heroin use and that one fifth of patients will exit treatment following detox completion within a 1- to 2-year time frame.

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Section: Blood-borne Viral Infection Outcomessupporting

confidence: 85%

Outcome of heroin-dependent adolescents presenting for opiate substitution treatment

Smyth

Fagan²,

Kernan³

2012

Journal of Substance Abuse Treatment

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“…Altogether, the research suggests that there is broad variability in the average time to HCV seroconversion from the start of injection; within a range of between one and 5 years. Variability in this interval is probably related to IDU characteristics such as the frequency of injection and the number of injection partners [8,18,20]. Estimates of HCV prevalence may thus be affected by sampling methods, with some studies including a disproportionate sample of either high or low-risk IDU.…”

Section: Hepatitis C Virus Risk Factors In Injection Drug Usersmentioning

confidence: 98%

“…Studies have found that factors correlated with 'time at risk' are associated with prevalent HCV infection among IDU, including older age, a longer duration of drug injection and a high frequency of injection (Table 1) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A study of IDU admitted to drug treatment in six US cities reported an HCV prevalence between 66 and 93%, with a strong correlation between age and prevalence in each city [11].…”

Section: Hepatitis C Virus Risk Factors In Injection Drug Usersmentioning

confidence: 98%

HIV/hepatitis C virus co-infection in drug users: risk behavior and prevention

Hagan¹,

Thiede

Jarlais

2005

Aids

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Studies of HIV-positive patients have consistently shown that drug users, in particular injection drug users (IDU), are far more likely to have hepatitis C virus (HCV) infection than other patient groups. HIV incidence and prevalence in IDU has declined in recent years, but HCV remains endemic in this population. HCV antibody prevalence among non-injection users of drugs such as heroin and cocaine is between 5 and 30%, although there are scant data on specific transmission risk behavior. The control of HIV/HCV co-infection must address HCV prevention. Epidemiological studies have suggested that HCV prevalence in IDU is subject to various influences, some of which may be modifiable by interventions. However, studies have not shown consistent effects of various prevention strategies on HCV transmission, including studies of HCV screening and education, drug treatment or needle exchange. Although some large cross-sectional studies in regions where needle exchange is available to a large number of drug injectors have reported declining HCV prevalence, the scale of services needed is a matter of considerable debate and has not been systematically quantified. Priorities for research related to the prevention of HIV/HCV co-infection should include estimating the effect on disease occurrence of eliminating specific risk factors, and specifying the level of resources needed to alter HCV incidence.

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“…In New South Wales (NSW), the prevalence of hepatitis C among prisoners is approximately 40 times that of the general community [5,6]. While prisons are considered to be a high risk environment for blood borne virus transmission, most hepatitis C incidence studies have been conducted among injecting drug users (IDU) in the community setting [7][8][9][10]. Understanding the epidemiology of hepatitis C transmission within the correctional setting is necessary to inform the development of harm reduction programmes and policies appropriate for this setting.…”

Section: Introductionmentioning

confidence: 99%