Age-related Differences in Past or Present HCV Infection among People Who Inject Drugs - National HIV Behavioral Surveillance, Eight U.S Cities, 2015
Historically, older people who inject drugs (PWID) have had the highest hepatitis C burden, however, young PWID account for recent increases in HCV infection. We assessed factors associated with past or present HCV infection (HCV antibody-positive) among young (≤35 years) and older PWID (>35 years).
Using Poisson regression, we calculated adjusted prevalence ratios (aPR) to examine socio-demographic and past 12-month injection risk behaviors associated with HCV infection.
Of 4,094 PWID, 55.2% were HCV antibody-positive (anti-HCV). Among young PWID, anti-HCV prevalence was 42.1% and associated with ≤high school diploma/GED (aPR=1.17, 95%CI=1.03-1.32), receptive syringe sharing (aPR=1.37, 95%CI=1.21-1.56), sharing injection equipment (aPR=1.16, 95%CI=1.01-1.35), arrest history (aPR=1.14, 95%CI=1.02-1.29), and injecting speedball (aPR=1.37, 95%CI=1.16-1.61). Among older PWID, anti-HCV prevalence was 62.2% and associated with ≤high school diploma/GED (aPR= 1.08, 95%CI=1.02-1.15), sharing injection equipment (aPR=1.08, 95% CI=1.02-1.15), high injection frequency (aPR=1.16, 95%CI=1.01-1.34), and injecting speedball (aPR=1.09, 95%CI=1.01-1.16).
Anti-HCV positivity prevalence is high and associated with risky injection practices. Almost half of young PWID were anti-HCV positive. Improving access to direct-acting antiviral treatment, syringe service programs, and medication-assisted therapy are critical to reducing HCV transmission risk and infection burden, particularly among young PWID who are more likely to be newly infected.
Division of Viral Hepatitis, Centers for Disease Control and Prevention.
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention.
Division of Allergy and Infectious Diseases, School of Medicine, University of Washington.
Denver Public Health, Denver Health and Hospital Authority.
STD/HIV Program, Louisiana Department of Health and Hospitals.
Chicago Department of Public Health.
Los Angeles County Department of Public Health.
Bureau of HIV/AIDS Epidemiology, New York State Department of Health.
TB/HIV/STD Branch, Texas Department of State Health Services.
Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene.