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Age- and time-dependent prevalence and incidence of hepatitis C virus infection in drug users in France, 2004–2011: model-based estimation from two national cross-sectional serosurveys

  • L. LEON (a1), S. KASEREKA (a1), F. BARIN (a2), C. LARSEN (a1), L. WEILL-BARILLET (a1), X. PASCAL (a1), S. CHEVALIEZ (a3), J. PILLONEL (a1), M. JAUFFRET-ROUSTIDE (a1) (a4) and Y. LE STRAT (a1)...
Summary
SUMMARY

Hepatitis C virus (HCV) infection is a public health issue worldwide. Injecting drug use remains the major mode of transmission in developed countries. Monitoring the HCV transmission dynamic over time is crucial, especially to assess the effect of harm reduction measures in drug users (DU). Our objective was to estimate the prevalence and incidence of HCV infection in DU in France using data from a repeated cross-sectional survey conducted in 2004 and 2011. Age- and time-dependent HCV prevalence was estimated through logistic regression models adjusted for HIV serostatus or injecting practices. HCV incidence was estimated from a mathematical model linking prevalence and incidence. HCV prevalence decreased from 58·2% [95% confidence interval (CI) 49·7–66·8] in 2004 to 43·2% (95% CI 38·8–47·7) in 2011. HCV incidence decreased from 7·9/100 person-years (95% CI 6·4–9·4) in 2004 to 4·4/100 person-years (95% CI 3·3–5·9) in 2011. HCV prevalence and incidence were significantly associated with age, calendar time, HIV serostatus and injecting practices. In 2011, the highest estimated incidence was in active injecting DU (11·2/100 person-years). Given the forthcoming objective of generalizing access to new direct antiviral agents for HCV infection, our results contribute to decision-making and policy development regarding treatment scale-up and disease prevention in the DU population.

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Corresponding author
*Author for correspondence: Ms. L. Léon, Santé publique France, French National Public Health Agency, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex France. (Email: Lucie.Leon@santepubliquefrance.fr)
References
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1. Mathers BM, et al. Mortality among people who inject drugs: a systematic review and meta-analysis. Bulletin of the World Health Organization 2013; 91: 102123.
2. Iversen J, et al. Reduction in HCV incidence among injection drug users attending needle and syringe programs in Australia: a linkage study. American Journal of Public Health 2013; 103: 14361444.
3. Martin NK, et al. Hepatitis C virus treatment for prevention among people who inject drugs: Modeling treatment scale-up in the age of direct-acting antivirals. Hepatology 2013; 58: 15981609.
4. Wiessing L, et al. Hepatitis C virus infection epidemiology among people who inject drugs in Europe: a systematic review of data for scaling up treatment and prevention. PLoS ONE 2014; 9: e103345.
5. De Vos AS, et al. Decline in incidence of HIV and hepatitis C virus infection among injecting drug users in Amsterdam; evidence for harm reduction? Addiction 2013; 108: 10701081.
6. Craine N, et al. Incidence of hepatitis C in drug injectors: the role of homelessness, opiate substitution treatment, equipment sharing, and community size. Epidemiology and Infection 2009; 137: 12551265.
7. Bravo MJ, et al. HCV seroconversion among never-injecting heroin users at baseline: no predictors identified other than starting injection. International Journal of Drug Policy 2012; 23: 415419.
8. Sun H-Y, et al. Recent hepatitis C virus infections in HIV-infected patients in Taiwan: incidence and risk factors. Journal of Clinical Microbiology 2012; 50: 781787.
9. Luciani F, et al. A prospective study of hepatitis C incidence in Australian prisoners. Addiction 2014; 109: 16951706.
10. Balogun M, et al. Prevalence and incidence of hepatitis C in injecting drug users attending genitourinary medicine clinics. Epidemiology and Infection 2009; 137: 980987.
11. Page-Shafer K, et al. Testing strategy to identify cases of acute hepatitis C virus (HCV) infection and to project HCV incidence rates. Journal of Clinical Microbiology 2008; 46: 499506.
12. Hope V, et al. Measuring the incidence, prevalence and genetic relatedness of hepatitis C infections among a community recruited sample of injecting drug users, using dried blood spots. Journal of Viral Hepatitis 2011; 18: 262270.
13. Busch MP, Shafer KAP. Acute-phase hepatitis C virus infection: implications for research, diagnosis, and treatment. Clinical Infectious Diseases 2005; 40: 959961.
14. Brant L, et al. Diagnosis of acute hepatitis C virus infection and estimated incidence in low-and high-risk English populations. Journal of Viral Hepatitis 2008; 15: 871877.
15. Cullen K, et al. Factors associated with recently acquired hepatitis C virus infection in people who inject drugs in England, Wales and Northern Ireland: new findings from an unlinked anonymous monitoring survey. Epidemiology and Infection 2015; 143: 13981407.
16. Shepherd SJ, et al. A hepatitis C avidity test for determining recent and past infections in both plasma and dried blood spots. Journal of Clinical Virology 2013; 57: 2935.
17. Patel EU, et al. Use of hepatitis C virus (HCV) immunoglobulin G antibody avidity as a biomarker to estimate the population-level incidence of HCV infection. Journal of Infectious Diseases 2016: jiw005.
18. Gaudy-Graffin C, et al. Use of an anti-hepatitis C virus (HCV) IgG avidity assay to identify recent HCV infection. Journal of Clinical Microbiology 2010; 48: 32813287.
19. Jauffret-Roustide M, et al. A national cross-sectional study among drug-users in France: epidemiology of HCV and highlight on practical and statistical aspects of the design. BMC Infectious Diseases 2009; 9: 1.
20. Weill-Barillet L, et al. Hepatitis C virus and HIV seroprevalences, sociodemographic characteristics, behaviors and access to syringes among drug users, a comparison of geographical areas in France, ANRS-Coquelicot 2011 survey. Revue d'Épidémiologie et de Santé Publique 2016.
21. Leon L, Jauffret-Roustide M, Le Strat Y. Design-based inference in time-location sampling. Biostatistics 2015; 16: 565579.
22. Semaille C, et al. Monitoring the dynamics of the HIV epidemic using assays for recent infection and serotyping among new HIV diagnoses: experience after 2 years in France. Journal of Infectious Diseases 2007; 196: 377383.
23. Bollaerts K, et al. Estimating the population prevalence and force of infection directly from antibody titres. Statistical Modelling 2012; 12: 441462.
24. Korn EL, Graubard BI. Analysis of Health Surveys: John Wiley & Sons, 2011.
25. Binder H, Sauerbrei W, Royston P. Comparison between splines and fractional polynomials for multivariable model building with continuous covariates: a simulation study with continuous response. Statistics in Medicine 2013; 32: 22622277.
26. Royston P, Ambler G, Sauerbrei W. The use of fractional polynomials to model continuous risk variables in epidemiology. International Journal of Epidemiology 1999; 28: 964974.
27. Shkedy Z, et al. Modelling age-dependent force of infection from prevalence data using fractional polynomials. Statistics in Medicine 2006; 25: 15771591.
28. Cousien A, et al. Dynamic modelling of hepatitis C virus transmission among people who inject drugs: a methodological review. Journal of Viral Hepatitis 2015; 22: 213229.
29. Le Page A, Robertson P, Rawlinson W. Discordant hepatitis C serological testing in Australia and the implications for organ transplant programs. Journal of Clinical Virology 2013; 57: 1923.
30. Smit C, et al. Risk of hepatitis-related mortality increased among hepatitis C virus/HIV-coinfected drug users compared with drug users infected only with hepatitis C virus: a 20-year prospective study. JAIDS Journal of Acquired Immune Deficiency Syndromes 2008; 47: 221225.
31. Horvitz DG, Thompson DJ. A generalization of sampling without replacement from a finite universe. Journal of the American statistical Association 1952; 47: 663685.
32. Lucidarme D, et al. Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France. Epidemiology and Infection 2004; 132: 699708.
33. Anon. Hepatitis C in the UK. Public Health England, 2014.
34. Wandeler G, et al. Hepatitis C virus infections in the Swiss HIV Cohort Study: a rapidly evolving epidemic. Clinical Infectious Diseases 2012: cis694.
35. Jauffret-Roustide M, et al. High biological-based HCV incidence and increasing frequency of high-risk practices among IDUs in Paris: What are the implications for harm reduction models? First European Conference on Addictive Behaviours and Dependencies, 2015.
36. Martin NK, et al. Cost-effectiveness of hepatitis C virus antiviral treatment for injection drug user populations. Hepatology 2012; 55: 4957.
37. Jauffret-Roustide M, Pedrono G, Beltzer N. Supervised consumption rooms: the French Paradox. International Journal of Drug Policy 2013; 24: 628630.
38. Castro Sanchez AY, et al. A mathematical model for HIV and hepatitis C co-infection and its assessment from a statistical perspective. Epidemics 2013; 5: 5666.
39. Hagan H, et al. Hepatitis C virus infection among HIV-positive men who have sex with men: protocol for a systematic review and meta-analysis. Systematic reviews 2014; 3: 1.
40. Cousien A, et al. Hepatitis C treatment as prevention of viral transmission and liver-related morbidity in persons who inject drugs. Hepatology 2015.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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