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    The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs

    Access Status
    Fulltext not available
    Authors
    Aitken, C.
    Agius, P.
    Higgs, Peter
    Stoové, M.
    Bowden, D.
    Dietze, P.
    Date
    2017
    Type
    Journal Article
    
    Metadata
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    Citation
    Aitken, C. and Agius, P. and Higgs, P. and Stoové, M. and Bowden, D. and Dietze, P. 2017. The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs. Epidemiology and Infection. 145 (4): pp. 796-801.
    Source Title
    Epidemiology and Infection
    DOI
    10.1017/S0950268816002892
    ISSN
    0950-2688
    School
    National Drug Research Institute (NDRI)
    URI
    http://hdl.handle.net/20.500.11937/54194
    Collection
    • Curtin Research Publications
    Abstract

    Copyright © Cambridge University Press 2016.Although high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs' use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7.6 [95% confidence interval (CI) 4.8-11.9], 12.4 (95% CI 9.1-17.0) and 9.7 (95% CI 7.4-12.6) per 100 person-years, respectively. Needle-sharing was significantly associated with higher incidence of naive HCV infection [hazard ratio (HR) 4.9, 95% CI 1.3-17.7] but not reinfection (HR 1.85, 95% CI 0.79-4.32); however, a cross-model test suggested this difference was sample specific. Past month use of OST had non-significant protective effects against naive HCV infection and reinfection. Our data confirm previous evidence of greatly reduced HCV incidence in PWID, but not the significant protective effect of OST on HCV incidence detected in recent studies. Our findings reinforce the need for greater access to HCV testing and prevention services to accelerate the decline in incidence, and HCV treatment, management and support to limit reinfection.

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