Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

Abstract

Injection drug users (IDUs) are at risk for infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Information on time trends in prevalence of these viruses among IDUs and in behaviors influencing their transmission can help define the status of these epidemics and of public health efforts to control them. We conducted a secondary data analysis combining crosssectional data from IDUs aged 18-30 years enrolled in four Seattle-area studies from 1994 to 2004. Participants in all four studies were tested for antibody to HIV (anti-HIV), hepatitis B core antigen (anti-HBc), and HCV (anti-HCV), and completed behavioral risk assessments. Logistic regression was used to investigate trends in prevalence over time after controlling for sociodemographic, drug use, and sexual behavior variables. Between 1994 and 2004, anti-HBc prevalence declined from 43 to 15% (p G 0.001), anti-HCV prevalence fell from 68 to 32% (p G 0.001) and anti-HIV prevalence remained constant at 2-3%. Declines in anti-HBc and anti-HCV prevalence were observed within the individual studies, although not all these declines were statistically significant. The declines in anti-HBc and anti-HCV prevalence remained significant after control for confounding. Although we did not observe coincident declines in injection equipment sharing practices, there were increases in self-reported needle-exchange use, condom use, and hepatitis B vaccination. We conclude that there has been a substantial and sustained reduction in prevalence rates for HBV and HCV infection among young Seattle IDUs, while HIV rates have remained low and stable.

Traveling young injection drug users at high risk for acquisition and transmission of viral infections

“…The finding of increased injecting risk taken together with increased HCV prevalence suggest that travel may be an important factor in both the acquisition and transmission of HCV. We note that the prevalence of HCV in young IDU in our studies has decreased from 45% in 308 young IDU studied from 1997 to 1999 (Hahn et al, 2001), to 39% in young IDU studied from 2000 to 2001 to 35% in this study, consistent with recent reports of declining HCV prevalence in IDU in other cities (Burt et al, 2007;Des Jarlais et al, 2005a). However, this trend may not be sustained given the high level of injecting risk behavior reported by the travelers in this study.…”

Hepatitis C Virus Acquisition among Injecting Drug Users: A Cohort Analysis of a National Repeated Cross-sectional Survey of Needle and Syringe Program Attendees in Australia, 1995–2004

“…To date, there has been limited published data internationally on trends in HCV infection and related risk factors in IDU populations over significant time periods, with studies examining trends in prevalent HCV infection being limited to IDUs recruited via drug treatment facilities 11 or comparison of different data sources over time. 12 While studies published in HIV [13][14][15] and cancer epidemiology 16 have used various statistical methods to estimate trends in incident infection from prevalence data when cohort studies were not feasible, we are not aware of similar methods being applied to routinely collected HCV prevalence data.…”

The pathway to substance misuse for young people with ADHD and conduct disorder

“…Untreated substance dependence also contributes to individuals engaging in drug-related crime, which in turn may lead to recidivism (Baillargeon et al, 2010). Furthermore, in the criminal justice setting, SUD are often accompanied by insalubrious practices that lead to blood-borne pathogen infections such as Hep C and HIV (Albizu-Garcia, Caraballo, Caraballo-Correa, Hernandez-Viver, & Roman-Badenas, 2012; Burt et al, 2007;Pena-Orellana, Hernandez-Viver, Caraballo-Correa, & Albizu-Garcia, 2011). …”