NDLI: Hepatitis C virus acquisition among injecting drug users: a cohort analysis of a national repeated cross-sectional survey of needle and syringe program attendees in Australia, 1995-2004.

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Hepatitis C virus acquisition among injecting drug users: a cohort analysis of a national repeated cross-sectional survey of needle and syringe program attendees in Australia, 1995-2004.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Falster, Kathleen Kaldor, John M. Maher, Lisa
Spatial Coverage	Australia
Description	Country affiliation: Australia Author Affiliation: Falster K ( National Centre in HIV Epidemiology and Clinical Research, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. kfalster@nchecr.unsw.edu.au)
Abstract	High hepatitis C virus (HCV) prevalence has been documented among many injecting drug user (IDU) populations worldwide; however, there is limited published data on trends in incidence of infection in these epidemics over time. To address this, we used a novel method of analyzing data collected via repeat, cross-sectional sero-surveys by injection initiation cohorts to investigate trends in HCV seropositivity among a population of needle and syringe program (NSP) attendees in Australia between 1995 and 2004, and thereby infer annual incidence trends. Injection initiation cohorts were defined by their time of entry into the IDU population. We also investigated the associations between HCV antibody seroprevalence and risk factor data, and trends in risk factor data over the decade. Approximately 20,000 NSP attendees participated in the study over the 10-year period. Within each injection initiation cohort, we found an increase in HCV prevalence over time, with prevalence appearing to reach saturation around 90%. There was little indication that the slopes of increase had changed with more recent initiation cohorts. While duration of injecting was most strongly associated with HCV seropositivity in this study, we also found that self-reported history of needle and syringe sharing and imprisonment were independently associated with higher HCV prevalence regardless of duration of injecting, with the exception of IDUs who have 15 or more years injecting experience. In this group, recent risk behavior had no relationship to prevalence. In summary, our findings suggest a persistent HCV epidemic despite significant harm reduction efforts in Australia since the mid-1980s, with HIV incidence effectively constant in successive initiation cohorts.
File Format	HTM / HTML
ISSN	10993460
e-ISSN	14682869
DOI	10.1007/s11524-008-9330-7
Journal	Journal of Urban Health
Issue Number	1
Volume Number	86
Language	English
Publisher	Springer
Publisher Date	2009-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Epidemiology Discipline Public Health Hepatitis C Epidemiology Transmission Needle-exchange Programs Statistics & Numerical Data Substance Abuse, Intravenous Cohort Studies Cross-sectional Studies Health Surveys Complications Hepatitis C Antibodies Blood Risk-taking Time Factors Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Urban Studies Health (social science) Public Health, Environmental and Occupational Health

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