Major decline of hepatitis C virus incidence rate over two decades in a cohort of drug users |
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Authors: | Charlotte H S B van den Berg Colette Smit Margreet Bakker Ronald B Geskus Ben Berkhout Suzanne Jurriaans Roel A Coutinho Katja C Wolthers Maria Prins |
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Institution: | (1) Department of Human Retrovirology, Academic Medical Center, Amsterdam, The Netherlands;(2) Department of Research, Cluster, Infectious Diseases, Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands;(3) Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands;(4) Center for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands;(5) Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands |
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Abstract: | Injecting drug users (DU) are at high risk for hepatitis C virus (HCV) and HIV infections. To examine the prevalence and incidence
of these infections over a 20-year period (1985–2005), the authors evaluated 1276 DU from the Amsterdam Cohort Studies who
had been tested prospectively for HIV infection and retrospectively for HCV infection. To compare HCV and HIV incidences,
a smooth trend was assumed for both curves over calendar time. Risk factors for HCV seroconversion were determined using Poisson
regression. Among ever-injecting DU, the prevalence of HCV antibodies was 84.5% at study entry, and 30.9% were co-infected
with HIV. Their yearly HCV incidence dropped from 27.5/100 person years (PY) in the 1980s to 2/100 PY in recent years. In
multivariate analyses, ever-injecting DU who currently injected and borrowed needles were at increased risk of HCV seroconversion
(incidence rate ratio 29.9, 95% CI 12.6, 70.9) compared to ever-injecting DU who did not currently inject. The risk of HCV
seroconversion decreased over calendar time. The HCV incidence in ever-injecting DU was on average 4.4 times the HIV incidence,
a pattern seen over the entire study period. The simultaneous decline of both HCV and HIV incidence probably results from
reduced risk behavior at the population level.
Charlotte H.S.B. van den Berg and ColetteSmit contributed equally to this paper |
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Keywords: | Hepatitis C virus Hepatitis C incidence HIV incidence Parenteral drug abuse |
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