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. 2020 Aug 20;3(3):276-285.
doi: 10.3138/canlivj.2019-0023. eCollection 2020 Summer.

Sociodemographic risk factors for hepatitis C virus infection in a prospective cohort study of 257 persons in Canada who inject drugs

Faustyna Zietara  1 , Pam Crotty  1 , Michael Houghton  2 , Lorne Tyrrell  2 , Carla S Coffin  1 , Gisela Macphail  3   4
Affiliations

Sociodemographic risk factors for hepatitis C virus infection in a prospective cohort study of 257 persons in Canada who inject drugs

Faustyna Zietara et al. Can Liver J. .

Abstract

Background: Approximately 60% of incident hepatitis C virus (HCV) infections are due to intravenous drug use; therefore, understanding the socio-demographics of people who inject drugs (PWID) is necessary to achieve HCV elimination.

Methods: In this prospective cohort study of PWID, we determined patients' baseline HCV antibody, hepatitis B virus (HBV), and HIV serological status. HCV antibody- negative (anti-HCV-negative) cases were followed for seroconversion (median 17 mo with q3m testing) as part of a larger study to develop a vaccine for HCV. An interviewer-administered baseline questionnaire completed with all patients evaluated socio-demographic and clinical characteristics.

Results: We tested 257 PWID (median age 40 [range 49-31]y, 81% men, 63% Caucasian, 28% Indigenous). Of these, 28% were positive for HCV antibodies (anti-HCV-positive) (median age 42 [range 49-36]y, 74% men, 69% Caucasian, 29% Indigenous). Compared with anti-HCV-negative PWID, anti-HCV-positive PWID reported injecting more morphine and hydromorphone, using more hydromorphone via non-injection routes, and were more likely to be enrolled in methadone programs. More than 60% reported previous HCV testing, but recent testing (<2 y) was more frequent in the anti-HCV-negative group (p = 0.03). All were HBV negative, but more than 50% of the anti-HCV-positive group had anti-HBs titres more than 10 IU/L compared with 35% of the anti-HCV-negative group (p = 0.01), and 3 of 257 were HIV positive (1 co-infected with HCV-HIV).

Conclusions: In this prospective study, differences in age, timing of HCV testing and risk behaviours were found between anti-HCV-positive and anti-HCV-negative groups.

Keywords: HCV testing; PWID; hepatitis C; intravenous drug use; socio-demographic.

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Conflict of interest statement

Dr Coffin has received investigator- initiated research grant support from Gilead Sciences and GSK and served on an advisory board for SpringBank Pharmaceuticals and Altimmune in the past 24 months. Dr Macphail reports grants from Collaborative Research and Innovation Opportunity through Alberta Innovates Health Solutions during the conduct of the study; grants, personal fees, and non-financial support from Gilead Sciences; grants, personal fees, and non-financial support from Merck Canada; personal fees and non-financial support from AbbVie Canada; grants from Coverdale Clinics–Bioscript Solutions, outside the submitted work.

Figures

Figure 1:
Figure 1:
Length of time participants lived in Calgary
Figure 2:
Figure 2:
Area of city in which participants spent the most time
Figure 3:
Figure 3:
Barriers to accessing addiction services
See this image and copyright information in PMC

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