Self-Reported Hepatitis C Virus Antibody Status and Risk Behavior in Young Injectors

Center for Drug Use and HIV Research, National Development and Research Institutes, 8th Fl, 71 West 23rd St., NY, NY 10010, USA.
Public Health Reports (Impact Factor: 1.55). 11/2006; 121(6):710-9.
Source: PubMed


This study was conducted to assess the accuracy of self-reported hepatitis C virus (HCV) antibody (anti-HCV) serostatus in injection drug users (IDUs), and examine whether self-reported anti-HCV serostatus was associated with recent injection risk behavior.
In five U.S. cities (Baltimore, Chicago, Los Angeles, New York, and Seattle), 3,004 IDUs from 15 to 30 years old were recruited for a baseline interview to determine eligibility for a randomized controlled trial of a behavioral intervention. HIV and HCV antibody testing were performed, and subject data (e.g., demographics, drug and sexual risk behavior, and history of HIV and HCV testing) were collected via audio computer-administered self-interview. Risk behavior during the previous three months was compared to self-reported anti-HCV serostatus.
Anti-HCV prevalence in this sample of young IDUs was 34.1%. Seventy-two percent of anti-HCV-positive and 46% of anti-HCV-negative IDUs in this sample were not aware of their HCV serostatus. Drug treatment or needle exchange use was associated with increased awareness of HCV serostatus. Anti-HCV-negative IDUs who knew their serostatus were less likely than those unaware of their status to inject with a syringe used by another IDU or to share cottons to filter drug solutions. Knowledge of one's positive anti-HCV status was not associated with safer injection practices.
Few anti-HCV-positive IDUs in this study were aware of their serostatus. Expanded availability of HCV screening with high quality counseling is clearly needed for this population to promote the health of chronically HCV-infected IDUs and to decrease risk among injectors susceptible to acquiring or transmitting HCV.

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Available from: Steffanie A Strathdee,
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    ABSTRACT: Purpose: Hawaii had the highest incidence of liver cancer in the US and had a unique patient population with many immigrants from the Pacific and Asia where Hepatitis B virus (HBV) was en-demic. HBV screening in high risk populations was a recommended measure of preventative medicine , thus we sought to examine physician screening patterns for HBV in Hawaii. Methods: We retrospectively analyzed billing claims from 1999 to 2009 from the largest healthcare coverage provider in the state of Hawaii. We identified all patients (>18 years) who underwent HBV screening based on Current Procedural Terminology (CPT) billing codes. We collected data on age, gender and specialty of physicians ordering the screening tests. Analysis was done in 2013 and 2014. Results: Of an estimated 700,000 covered lives, 125,576 patients underwent HBV screening. We stratified the patients into two eras from 1999-2004 (N = 52,245) and 2005-2009 (N = 73,331) to examine temporal trends. In the first era, 30,975 women (59.3%) underwent HBV screening, compared to 49,950 women (69.1%) screened in the 2005-2009 era. There absolute number of tests increased, but the proportion done by primary care MDs decreased from 55.6% to 44.9%. OB/GYN screened 15.6% in the early era and 26.9% in later era. Conclusions: There was an increase in women aged 18-40 years screened in the 2005-2009 era compared to 1999-2004, most likely due to OB/GYN physicians' screening of prenatal women. Physician education on HBV vaccination/tr-eatment or appropriate referral should include OB/GYN as well as primary care physicians.
    Open Journal of Gastroenterology 10/2015; 5(10):139-145. DOI:10.4236/ojgas.2015.510023
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    • "Historical estimates suggest that less than 2% of persons with HCV are cured through treatment (based on estimates that 25% of persons with HCV are detected through screening,8 77% are referred to HCV care, 66% attend care,21 26% initiate care,22,23 and around 60% achieve SVR). A more recent analysis suggested that as many as 9% of persons with HCV may achieve SVR.24 "
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    ABSTRACT: The US faces at least two distinct epidemics of hepatitis C virus infection (HCV), and due largely to revised screening recommendations and novel therapeutic agents, corresponding opportunities. As only 49%-75% of HCV-infected persons in the US are aware of their infection, any chance of addressing HCV in the US is dependent upon screening to identify undiagnosed infections. Most HCV in the US consists of longstanding infections among persons born during 1945-1965 who are suffering escalating rates of liver-related morbidity and mortality. Mathematical modeling supports aggressive action to reach and treat these persons to minimize the subsequent burden of advanced liver disease on patients and the health care system. Incident infection is primarily among persons who inject drugs, less than 10% of whom have been treated for HCV. Expanded screening and treatment of active persons who inject drugs raises the prospect of utilizing "treatment as prevention" to stem the tide of incident HCV infections in this population. HIV-positive men who have sex with men (MSM) represent a population at risk for sexually transmitted HCV who may also benefit from adjusted screening guidelines to identify both acute and chronic infections. Prisoners also represent a critical population for aggressive screening and treatment. Finally, the two-stage testing algorithm for HCV diagnosis is problematic and difficult for patients and providers to navigate. While emerging therapeutics raise the prospect of reducing HCV-related morbidity and mortality, as well as eliminating new infections, major barriers remain with regard to identifying infections, improving access to treatment, and ensuring payer coverage of costly new therapeutic regimens.
    Hepatic Medicine: Evidence and Research 07/2014; 6:79-87. DOI:10.2147/HMER.S40940
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    • "Testing for HCV may enhance prevention efforts, improve efforts to identify people eligible for treatment, and increase uptake into care [3,21-24]. Some studies suggest that PWID who know their serostatus may reduce some high-risk injection-related behaviors [25-27], however others have not observed this [22,24,28]. Young PWID may also engage in seroadaptive practices, based on their perception of their partners’ HCV status [18,29], although others have not observed this [22,24,28,30,31]. "
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