Markers and risk factors for HCV, HBV and HIV in a network of injecting drug users in Melbourne, Australia

• Published in: The Journal of infection Vol. 58; no. 5; pp. 375 - 382
• Main Authors: Miller, E.R, Hellard, M.E, Bowden, S, Bharadwaj, M, Aitken, C.K
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-05-2009; Elsevier
• Subjects: Adolescent; Adult; Antibodies, Viral - blood; Australia - epidemiology; Biological and medical sciences; Drug addictions; Drug injectors; Drug Users - statistics & numerical data; Female; General aspects; Hepatitis B - blood; Hepatitis B - epidemiology; Hepatitis B virus; Hepatitis C - blood; Hepatitis C - epidemiology; Hepatitis C virus; HIV; HIV Infections - blood; HIV Infections - epidemiology; HIV Seropositivity; Human immunodeficiency virus; Human viral diseases; Humans; Infectious Disease; Infectious diseases; Male; Medical sciences; Middle Aged; Prevalence; Risk Factors; Substance Abuse, Intravenous - blood; Substance Abuse, Intravenous - epidemiology; Time Factors; Toxicology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Australia; Oceania; Drug injectors; Hepatitis B virus; HIV; Hepatitis C virus; Risk factors; Human; Immunopathology; Drug addiction; Orthohepadnavirus; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Hepadnaviridae; Viral disease; Risk factor; Network; Human immunodeficiency virus; Flaviviridae; Hepacivirus
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2009.02.014

Summary Background and aims Current injecting drug users (IDU) in major street drug markets within greater Melbourne were recruited to a longitudinal study on blood borne viruses. Here we investigated risk factors for hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV infection in these IDU at the time of their recruitment. Methods Three hundred and eighty-two IDU completed detailed questionnaires on their drug use and risk behaviours, and provided blood samples for serology testing. These data were analysed using univariate and multivariate techniques. Results The overall prevalence of exposure to HCV, HBV and HIV was estimated at 70%, 34% and <1%, respectively. Independent predictors of HCV exposure were history of imprisonment (RR 1.34, 95% CI 1.19–1.52), use of someone else's needle or syringe (RR 1.23, 95% CI 1.07–1.42), >7.6 years length of time injecting (RR 1.21, 95% CI 1.07–1.37), and originating from Vietnam (RR 1.12, 95% CI 1.07–1.18). Independent predictors of HBV exposure were HCV exposure (RR 2.15, 95% CI 1.35–3.43), >7.6 years length of time injecting (RR 1.57, 95% CI 1.17–2.13) and originating from outside Australia (RR 1.60, 95% CI 1.22–2.10). Neither prison- nor community-applied tattoos predicted HCV or HBV exposure. Up to 31% of IDU who injected for 1 year or less were HCV antibody positive, as were 53% of those who injected for 2 years or less. Conclusions Ongoing engagement with young IDU, through the provision of harm reduction education and resources, is critical if we are to address blood borne viral infections and other health and social harms associated with injecting drug use.