Hepatitis C virus infection and co-infection with HIV among persons who inject drugs in 10 U.S. cities-National HIV Behavioral Surveillance, 2018

Johanna Chapin-Bardales; Alice Asher; Dita Broz; Eyasu Teshale; Tonya Mixson-Hayden; Amanda Poe; Senad Handanagic; Carlos Blanco; Cyprian Wejnert; NHBS HCV Study Group

doi:10.1016/j.drugpo.2024.104387

Hepatitis C virus infection and co-infection with HIV among persons who inject drugs in 10 U.S. cities-National HIV Behavioral Surveillance, 2018

Int J Drug Policy. 2024 Mar 25:104387. doi: 10.1016/j.drugpo.2024.104387. Online ahead of print.

Authors

Johanna Chapin-Bardales¹, Alice Asher², Dita Broz³, Eyasu Teshale², Tonya Mixson-Hayden², Amanda Poe², Senad Handanagic³, Carlos Blanco⁴, Cyprian Wejnert³; NHBS HCV Study Group

Affiliations

¹ Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: wif3@cdc.gov.
² Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA.
³ Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁴ Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA.

PMID: 38531730
DOI: 10.1016/j.drugpo.2024.104387

Abstract

Background: Characterizing acute and chronic hepatitis C virus (HCV) infection and HIV/HCV co-infection among persons who inject drugs (PWID) can inform elimination efforts.

Methods: During 2018 National HIV Behavioral Surveillance in 10 U.S. metropolitan statistical areas (MSAs), PWID were recruited using respondent-driven sampling and offered a survey, HIV testing, and HCV antibody and RNA testing. We examined prevalence and associated characteristics of HCV infection and HIV/HCV co-infection. Associations were assessed using log-linked Poisson regression models with robust standard errors accounting for clustering by recruitment chain and adjusting for MSA and network size.

Results: Overall, 44.2% had current HCV infection (RNA detected), with 3.9% classified as acute infection (HCV antibody non-reactive/RNA detected) and 40.3% as chronic (HCV antibody reactive/RNA detected). Four percent had HIV/HCV co-infection. Current HCV infection was significantly higher among PWID who were male, White, injected >1 time/day, shared syringes in past year, and shared injection equipment in past year. PWID who were transgender, injecting >5 years, and most often injected speedball (heroin and cocaine together) or stimulants alone were more likely to have HIV/HCV co-infection. Among PWID who never previously had HCV infection, 9.9% had acute HCV infection. Among PWID who started injecting ≤5 years ago, 41.5% had already acquired HCV infection.

Conclusions: Acute and chronic HCV infections were substantial among a sample of PWID in 10 U.S. MSAs. Accessibility to HCV RNA testing, promoting safer practices, and intervening early with harm reduction programs for recent injection initiates will be critical to disease elimination efforts for PWID.

Keywords: Acute HCV; HCV; HIV; Hepatitis C; PWID; Persons who inject drugs.