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Epidemiology and risk factors for hepatitis C virus infection in a high-prevalence population

  • M. A. Fill (a1) (a2) (a3), L. A. Sizemore (a2), M. Rickles (a2), K. C. Cooper (a4), C. M. Buecker (a5), H. L. Mullins (a6), M. G. Hofmeister (a1) (a7), W. E. Abara (a1) (a7), M. A. Foster (a7), A. K. Asher (a7), W. Schaffner (a3), J. R. Dunn (a2) (a3), T. F. Jones (a2) (a3) and C. Wester (a2)...
Abstract

To understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case–control study among persons who use drugs. During June–October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case–control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1–51.9), IDU alone (aOR 52.7, CI 25.3–109.9), intranasal drug use alone (aOR 2.6, CI 1.8–3.9) and incarceration (aOR 2.7, CI 2.0–3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1–18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.

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Corresponding author
Author for correspondence: Mary-Margaret A. Fill, E-mail: Mary-Margaret.Fill@tn.gov
References
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1. Edlin, BR, et al. (2015) Toward a more accurate estimate of the prevalence of hepatitis C in the United States. Hepatology 62, 13531363.
2. Yehia, BR, et al. (2014) The treatment cascade for chronic hepatitis C virus infection in the United States: a systematic review and meta-analysis. PLoS ONE 9, e101554.
3. Denniston, MM, et al. (2014) Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Annals of Internal Medicine 160, 293300.
4. Zibbell, JE, et al. (2015) Increase in hepatitis C virus infection related to injection drug use among persons age ⩽30 years – Kentucky, Tennessee, Virginia and West Virginia, 2006–2012. Morbidity and Mortality Weekly Report 64, 453458.
5. Suryaprasad, AG, et al. (2014) Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006–2012. Clinical Infectious Diseases 59, 14111419.
6. The National Academies Press ( 2016 ) Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report. April 2016. Available at http://www.nap.edu/23407 (Accessed 5 October 2017).
7. Harris, PA, et al. (2009) Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics 42, 377381.
8. U.S. Preventive Services Task Force (2016) Final Recommendation Statement: Hepatitis C: Screening. December 2016. Available at https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/hepatitis-c-screening (Accessed 11 January 2017).
9. Centers for Disease Control and Prevention (2015) Testing Recommendations for Hepatitis C Virus Infection. Updated October 15, 2015. Available at https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm (Accessed 13 January 2017).
10. Centers for Disease Control and Prevention (1998) Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. Morbidity and Mortality Weekly Report 47, 139.
11. Conry-Cantilena, C, et al. (1996) Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. New England Journal of Medicine 334, 16911696.
12. Allison, RD, et al. (2012) A 25-year study of the clinical and histological outcomes of hepatitis C virus infection and its modes of transmission in a cohort of initially asymptomatic blood donors. Journal of Infectious Diseases 206, 654661.
13. Vanhommerig, JW, et al. (2015) Risk factors for sexual transmission of hepatitis C virus among human immunodeficiency virus-infected men who have sex with men: a case-control study. Open Forum Infectious Diseases 2, ofv115.
14. Drainoni, ML, et al. (2012) Effectiveness of a risk screener in identifying hepatitis C virus in a primary care setting. American Journal of Public Health 102, e115e121.
15. Galperim, B, et al. (2004) Intranasal cocaine does not appear to be an independent risk factor for HCV infection. Addiction 99, 973977.
16. Scheinmann, R, et al. (2007) Non-injection drug use and Hepatitis C Virus: a systematic review. Drug and Alcohol Dependence 89, 112.
17. Des Jarlais, DC, et al. (2011) Can intranasal drug use reduce HCV infection among injecting drug users? Drug and Alcohol Dependence 119, 201206.
18. McMahon, JM, et al. (2004) Detection of hepatitis C virus in the nasal secretions of an intranasal drug-user. Annals of Clinical Microbiology and Antimicrobials 3, 6.
19. Aaron, S, et al. (2008) Intranasal transmission of hepatitis C virus: virological and clinical evidence. Clinical Infectious Diseases 47, 931934.
20. Almario, CV, et al. (2012) Examining hepatitis C virus testing practices in primary care clinics. Journal of Viral Hepatitis 19, 163169.
21. Weisbord, JS, et al. (2003) Prevalence of and risk factors for hepatitis C virus infection among STD clinic clientele in Miami, Florida. Sexually Transmitted Infections 79, E1.
22. Tolou-Shams, M, et al. (2007) Arrest history as an indicator of adolescent/young adult substance use and HIV risk. Drug and Alcohol Dependence 88, 8790.
23. Epperson, MW, et al. (2010) Assessing criminal justice involvement as an indicator of human immunodeficiency virus risk among women in methadone treatment. Journal of Substance Abuse Treatment 38, 375383.
24. Wise, A, et al. (2017) Incarceration, sexual risk-related behaviors, and HIV infection among women at increased risk of HIV infection, 20 United States cities. Journal of Acquired Immune Deficiency Syndromes 75(Suppl 3): S261S267.
25. Fendrich, M, et al. (2004) The utility of drug testing in epidemiological research: results from a general population survey. Addiction 99, 197208.
26. Zimmerman, R, et al. (2007) Integrating viral hepatitis prevention into STD clinics in Illinois (excluding Chicago), 1999–2005. Public Health Reports 122(Suppl 2): 1823.
27. Hennessy, RR, Weisfuse, IB and Schlanger, K (2007) Does integrating viral hepatitis services into public STD clinic attract injection drug users for care? Public Health Reports 122(Suppl 2): 3135.
28. American College of Obstetrician and Gynecologists (2007) Practice Bulletin no. 86: viral hepatitis in pregnancy. Obstetrics & Gynecology 110, 941956.
29. Kuncio, DE, et al. (2016) Failure to test and identify perinatally infected children born to hepatitis C virus-infected women. Clinical Infectious Diseases 62, 980985.
30. Prasad, MR and Honegger, JR (2013) Hepatitis C virus in pregnancy. American Journal of Perinatology 30, 149159.
31. Benova, L, et al. (2014) Vertical transmission of hepatitis C virus: systematic review and meta-analysis. Clinical Infectious Diseases 59, 765773.
32. Prasad, MR (2016) Hepatitis C virus screening in pregnancy: is it time to change our practice? Obstetrics & Gynecology 128, 229230.
33. Council of State and Territorial Epidemiologists (2017) Public Health Reporting and National Notification of Perinatal Hepatitis C Virus Infection (17-ID-08). Updated 2017. Available at http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2017PS/2017PSFinal/17-ID-08.pdf (Accessed 5 October 2017).
34. Safir, A, et al. (2010) Maternal hepatitis B or hepatitis C virus carrier status as an independent risk factor for adverse perinatal outcome. Liver International 30, 765770.
35. Fernandez, N, et al. (2016) Sharing of snorting straws and hepatitis C virus infection in pregnant women. Obstetrics & Gynecology 128, 234237.
36. Patrick, SW, et al. (2017) Hepatitis C infection among women giving birth – Tennessee and United States, 2009–2014. Morbidity and Mortality Weekly Report 66, 470473.
37. Frimpong, JA, D'Aunno, T and Jiang, L (2014) Determinants of the availability of hepatitis C testing services in opioid treatment programs: results from a national study. American Journal of Public Health 104, e75e82.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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