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Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: retrospective cohort study

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7156.433 (Published 15 August 1998) Cite this as: BMJ 1998;317:433
  1. Ingrid van Beek (ivanbeek{at}ozemail.com.au), directora,
  2. Robyn Dwyer, research coordinatora,
  3. Gregory J Dore, lecturer in epidemiologyb,
  4. Kehui Luo, statisticianb,
  5. John M Kaldor, deputy director, professor of epidemiologyb
  1. Kirketon Road Centre, PO Box 22, Kings Cross, New South Wales 1340, Australia
  2. National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia
  1. Correspondence to: Dr van Beek ivanbeek@ozemail.com.au
  • Accepted 5 May 1998

Abstract

Objectives: To estimate the incidence of HIV and hepatitis C virus and risk factors for seroconversion among a cohort of injecting drug users.

Design: Retrospective cohort study.

Setting: Primary healthcare facility in central Sydney.

Subjects: Injecting drug users tested for HIV-1 antibody (n=1179) and antibodies to hepatitis C virus (n=1078) from February 1992 to October 1995.

Main outcome measures: Incidence of HIV-1 and hepatitis C virus among seronegative subjects who injected drugs and underwent repeat testing. Demographic and behavioural risk factors for hepatitis seroconversion.

Results: Incidence of HIV-1 among 426 initially seronegative injecting drug users was 0.17/100 person years (two seroconversions) compared with an incidence of hepatitis C virus of 20.9/100 person years (31 seroconversions) among 152 injecting drug users initially negative for hepatitis C virus. Incidence of hepatitis C virus among injecting drug users aged less than 20 years was 75.6/100 person years. Independent risk factors for hepatitis C virus seroconversion were age less than 20 years and a history of imprisonment.

Conclusions: In a setting where prevention measures have contributed to the maintenance of low prevalence and incidence of HIV-1, transmission of hepatitis C virus continues at extremely high levels, particularly among young injecting drug users.

Key messages

  • The prevalence and incidence of hepatitis C virus is high, while the prevalence and incidence of HIV remains low among injecting drug users

  • Young age and history of imprisonment are risk factors for acquisition of hepatitis C virus infection

  • HIV prevention strategies have been relatively ineffective in preventing hepatitis C virus infection in this population

  • The role of imprisonment in the acquisition of hepatitis C infection should be further investigated

Footnotes

  • Accepted 5 May 1998
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