Sociodemographic risk factors for hepatitis C virus infection in a prospective cohort study of 257 persons in Canada who inject drugs

Abstract

BACKGROUND: Approximately 60% of incident hepatitis C virus (HCV) infections are due to intravenous drug use; therefore, understanding the socio-demographics of people who inject drugs (PWID) is necessary to achieve HCV elimination. METHODS: In this prospective cohort study of PWID, we determined patients’ baseline HCV antibody, hepatitis B virus (HBV), and HIV serological status. HCV antibody– negative (anti-HCV-negative) cases were followed for seroconversion (median 17 mo with q3m testing) as part of a larger study to develop a vaccine for HCV. An interviewer-administered baseline questionnaire completed with all patients evaluated socio-demographic and clinical characteristics. RESULTS: We tested 257 PWID (median age 40 [range 49–31]y, 81% men, 63% Caucasian, 28% Indigenous). Of these, 28% were positive for HCV antibodies (anti-HCV-positive) (median age 42 [range 49–36]y, 74% men, 69% Caucasian, 29% Indigenous). Compared with anti-HCV-negative PWID, anti-HCV-positive PWID reported injecting more morphine and hydromorphone, using more hydromorphone via non-injection routes, and were more likely to be enrolled in methadone programs. More than 60% reported previous HCV testing, but recent testing (<2 y) was more frequent in the anti-HCV-negative group ( p = 0.03). All were HBV negative, but more than 50% of the anti-HCV-positive group had anti-HBs titres more than 10 IU/L compared with 35% of the anti-HCV-negative group ( p = 0.01), and 3 of 257 were HIV positive (1 co-infected with HCV–HIV). CONCLUSIONS: In this prospective study, differences in age, timing of HCV testing and risk behaviours were found between anti-HCV-positive and anti-HCV-negative groups.

Hepatitis C (HCV) prevalence in citizens of the Métis Nation of Ontario

“…This finding aligns with studies conducted on the general population in Ontario, where an increased prevalence of HCV has been observed among individuals aged 60–69 [ 2 ] with individuals born between 1950 and 1964 having a higher likelihood of testing positive for HCV [ 16 ]. Furthermore, it is important to note that injection drug use accounts for 60–85% of new HCV infections in Canada [ 17 – 19 ]. Lourenço et al [ 18 ] has also shown that injection drug use is associated with lower levels of education and lower income.…”

Hepatitis B and C in Pregnancy and Children: A Canadian Perspective

“…Importantly, preconception planning promotes the management of risk factors and psychosocial aspects of HCV diagnosis prior to pregnancy including fear and stigma [ 25 ], while allowing clinicians and patients to collaborate on a plan of care that can include referrals to support resources and follow-up appointments. Canadian examples exist in the co-localization of trauma-informed care for women with HCV who use drugs [ 27 ], as well as the importance [ 28 ].…”