Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA. American Journal of Epidemiology
(Impact Factor: 5.23).
Designing studies to examine hepatitis C virus (HCV) transmission via the shared use of drug injection paraphernalia other than syringes is difficult because of saturation levels of HCV infection in most samples of injection drug users (IDUs). The authors measured the incidence of HCV infection in a large cohort of young IDUs from Chicago, Illinois, and determined the risk of HCV seroconversion associated with specific forms of sharing injection paraphernalia. From 1997 to 1999, serum samples obtained from 702 IDUs aged 18-30 years were screened for HCV antibodies; prevalence was 27%. Seronegative participants were tested for HCV antibodies at baseline, at 6 months, and at 12 months. During 290 person-years of follow-up, 29 participants seroconverted (incidence: 10.0/100 person-years). The adjusted relative hazard of seroconversion, controlling for demographic and drug-use covariates, was highest for sharing "cookers" (relative hazard = 4.1, 95% confidence interval: 1.4, 11.8), followed by sharing cotton filters (relative hazard = 2.4, 95% confidence interval: 1.1, 5.0). Risks associated with syringe-sharing and sharing of rinse water were elevated but not significant. After adjustment for syringe-sharing, sharing cookers remained the strongest predictor of seroconversion (relative hazard = 3.5, 95% confidence interval: 1.3, 9.9). The authors conclude that sharing of injection equipment other than syringes may be an important cause of HCV transmission between IDUs.
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- "zachowaniom, jak tatuowanie ciała, podejmowanie zachowań seksualnych obarczonych dużym ryzykiem oraz dzielenie sprzętu potrzebnego do wziewnego zażycia narkotyków. Szacuje się, że rozpowszechnienie HCV w populacji osób używających narkotyki iniekcyjnie (injection drug users; IDU) zawiera się w przedziale od 30 do 60%    . Badanie przeprowadzone w Polsce, w Gdańsku i Krakowie, w 2009 r. na próbie iniekcyjnych użytkowników narkotyków pokazały rozpowszechnienie przeciwciał HCV w tej populacji na poziomie 47,6%. "
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ABSTRACT: Drug users are particularly exposed to the risk of HCV infection. At the same time, this is a difficult group to reach out with preventive measures. The aim of the study was recognition of respondents’ needs for intervention to reduce hepatitis C virus infection, including the identification of preferences on the conditions of its implementation and execution.
- "The degree of insulin resistance (IR) was estimated for each patient using the homeostatic model assessment (HOMA): fasting plasma glucose (mmol/l) times fasting serum insulin (mU/l) divided by 22.5 (Matthews et al., 1985). The duration of HCV infection for patients with a history of intravenous drug use (IDU) was estimated starting from the first year they shared needles and other injection paraphernalia (Thorpe et al., 2002). For non-IDU patients, we only included those patients for which the initiation of their HCV infection could be determined with certainty. "
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ABSTRACT: Toll-like receptor 8 (TLR8) polymorphisms have been related to hepatitis C virus (HCV) infection. The aim was to estimate the association of TLR8 polymorphisms with HCV-related outcomes in HIV/HCV coinfected patients. We performed a cross-sectional study of 220 patients underwent a liver biopsy. TLR8 polymorphisms were genotyped using GoldenGate® assay. The outcome variables were non-fibrosis (F0), mild-inflammation (A0/A1), and non-steatosis [fatty hepatocytes (FH) <10%]. Logistic regression analysis was used to compare the outcome variables according to TLR8 polymorphisms. Four polymorphisms were analyzed (rs1013151, rs5744069, rs17256081 and rs3764880rs1013151). Female patients had higher frequency of TLR8 major alleles at rs17256081 and rs101315, and minor alleles at rs3764880 and rs5744069. Male patients had higher frequency of TLR8 minor alleles except for rs3764880, where major alleles were higher (p<0.01). Two TLR8 polymorphisms (rs1013151 and rs5744069) were significantly associated with non-fibrosis (F0) [adjusted odds ratio (aOR)=4.42 (95% of confidence interval (95%CI)=1.54; 12.68) (p=0.006) and aOR=4.76 (95%CI=1.69; 13.37) (p=0.003); respectively]. When data were stratified by gender, rs1013151 and rs5744069 polymorphisms remained significant for male patients [(adjusted odds ratio (aOR)=4.49 (95%CI=1.08; 18.62) (p=0.039) and aOR=6.17 (95%CI=1.45; 26.20) (p=0.014); respectively]. When data were stratified by major HCV genotypes, patients infected with HCV genotype 1 (GT1) had significant values for both rs1013151 and rs5744069 polymorphisms [aOR=5.79 (95%CI=1.44; 23.32) (p=0.013) and aOR=8.01 (95%CI=2.16; 35.65) (p=0.005); respectively]. Finally, none of the TLR8 polymorphisms were significantly associated with mild-inflammation or non-steatosis. In conclusion, TLR8 polymorphisms seem to be related to non-progression of liver fibrosis in HIV/HCV coinfected patients, particularly in males and those patients infected with GT1.
Available from: Meghan Diane Morris
- "sharing of contaminated needles/syringes and ancillary drug injecting equipment (Hagan et al., 2010; Nelson et al., 2011; Thorpe et al., 2002). Many structural and social constraints impact access to sterile injecting equipment, resulting in injection equipment sharing rates between 30-70% among people who inject drugs (PWID; Bruneau et al., 2008; Munoz et al., 2014; Pouget et al., 2012). "
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Studies have shown intimate injection partners engage in higher rates of syringe and injecting equipment sharing. We examined the drug use context and development of injection drug use behaviors within intimate injection partnerships.
In-depth interviews (n=18) were conducted with both members of nine injecting partnerships in Sydney, Australia. Content analysis identified key domains related to the reasons for injecting with a primary injection partner and development of drug injection patterns.
Most partnerships (n=5) were also sexual; three were blood-relatives and one a friend dyad. The main drug injected was heroin (66%) with high rates of recent sharing behaviors (88%) reported within dyads. Injecting within a primary injection partnership provided perceived protection against overdose events, helped reduce stress, increased control over when, where, and how drugs were used, and promoted the development of an injecting pattern where responsibilities could be shared. Unique to injecting within primary injection partnerships was the social connection and companionship resulted in a feeling of fulfillment while also blinding one from recognizing risky behavior.
Findings illuminated the tension between protection and risks within primary injection partnerships. Primary injection partnerships provide a potential platform to expand risk reduction strategies.
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