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. 2018 Feb;95(1):99-110.
doi: 10.1007/s11524-017-0207-5.

Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy

Enea Spada  1 , Giovanni Rezza  2 , Anna Rosa Garbuglia  3 , Flavia Lucia Lombardo  4 , Ornella Zuccaro  5 , Francesca Menniti Ippolito  4 , Elisabetta Cupellaro  6 , Stefania Capone  7 , Maria Rosaria Capobianchi  3 , Alfredo Nicosia  7   8   9 , Riccardo Cortese  9 , Antonella Folgori  7 , Alfonso Mele  10 ; Collaborative Study Group
Collaborators, Affiliations

Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy

Enea Spada et al. J Urban Health. 2018 Feb.

Abstract

So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007-2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis. Participants were mostly male (83.4%), under opioid substitution therapy (OST) (78.9%), non-injecting DUs (67.9%), and with a mean age of 30.8. Ninety-one of 224 DUs initially under OST interrupted treatment during the follow-up. Overall HCV incidence was 5.83/100 person-years at risk (PYAR) [95% confidence intervals (CI), 3.63-9.38]. The incidence did not significantly differ according the participants' sociodemographic characteristics or the degree of urbanization of the towns involved in the study. The incidence was higher for DUs under than for those not under OST (6.23 vs 4.50/100 PYAR; p = 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR; p = 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed.

Keywords: Hepatitis C virus; Illicit drug use; Incidence; Opioid substitution treatment; Risk factors; Seroconversion.

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References

    1. Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011;378:571–583. doi: 10.1016/S0140-6736(11)61097-0. - DOI - PMC - PubMed
    1. Scheinmann R, Hagan H, Lelutiu–Weinberger C, Stern R, et al. Non–injection drug use and hepatitis C virus: a systematic review. Drug Alcohol Depend. 2007;89:1–12. doi: 10.1016/j.drugalcdep.2006.11.014. - DOI - PMC - PubMed
    1. Hagan H, Pouget ER, Des Jarlais DC. A systematic review and meta–analysis of interventions to prevent hepatitis C virus infection in people who inject drugs. J Infect Dis. 2011;204:74–83. doi: 10.1093/infdis/jir196. - DOI - PMC - PubMed
    1. Wiessing L, Ferri M, Grady B, 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. doi: 10.1371/journal.pone.0103345. - DOI - PMC - PubMed
    1. Spada E, Mele A, Mariano A, et al. Risk factors for and incidence of acute hepatitis C after the achievement of blood supply safety in Italy: results from the national surveillance system. J Med Virol. 2013;85:433–440. doi: 10.1002/jmv.23485. - DOI - PubMed

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