[health-vn] Hepatitis C in Hanoi Heroin Users recently published in Journal Urban Health

[Peter Higgs]

Prevalence and Incidence of HCV Infection among Vietnam Heroin Users with Recent Onset of Injection 


Journal

Journal <http://www.springerlink.com/content/119977/?p=c720b99956da41298af6cae28f1f02bb&pi=0>  of Urban Health


Publisher

Springer New York


ISSN

1099-3460 (Print) 1468-2869 (Online)


Issue

Volume <http://www.springerlink.com/content/n03p16655364/?p=c720b99956da41298af6cae28f1f02bb&pi=0>  87, Number 2 / March, 2010


DOI

10.1007/s11524-009-9417-9


Pages

278-291

 

 

 


 

 

 


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Michael C. Clatts1, 4  <http://www.springerlink.com/content/6111xp18361378hn/#ContactOfAuthor1> Contact Information, Vivian Colón-López1, Le M. Giang2 and Lloyd A. Goldsamt3


(1) 

School of Public Health, University of Puerto Rico, San Juan, PR, USA

 


(2) 

Center for Research and Training on HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam

 


(3) 

National Development and Research Institutes, Inc., New York, NY, USA

 


(4) 

Center for Research on Global Health, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, PO Box 365067, San Juan, PR 00936-5067, USA

Published online: 30 December 2009 

Abstract  

HCV infection continues to spread at an alarming rate among IDU populations. The available evidence suggests that HCV is acquired relatively quickly following onset of injection. However, there are few prospective studies of HCV acquisition, particularly among IDU populations in resource-poor settings. A sample of young male heroin injectors with recent onset of injection (<4 years) was recruited in Hanoi, Vietnam for a prospective assessment of the early course of injection (n = 179). Both behavioral and biological assessments (including detailed retrospective assessment of injection initiation) were conducted at baseline and repeated at 6-month intervals for a period of 16 months. Variables associated with HCV infection (p value < 0.05) in bivariate analyses were considered for inclusion in logistic regression models to identify risk factors independently associated with HCV infection. HCV incidence was calculated by using the incidence density approach and was expressed in terms of person-years of observation. The baseline of prevalence of HCV was 46%. HCV significantly increased in relation to time since first injection, from 30% in subjects with ≤10 months of injection risk to 70% in subjects with ≥30 months injection risk (p value = 0.0005). In multivariate logistic regression analysis, increasing age, incarceration in a drug detention facility (OR = 2.54; 95%CI 1.05, 6.15), and time since first injection remained significantly associated with HCV infection. Use of injection as primary mode of administration (OR = 2.56; 95%CI 0.98, 6.69) achieved marginal significance. After 16 months of follow-up, the incidence rate of HCV was 23.35 per 100 person-years and the mean time between first injection and first positive HCV test was 1.2 years. HCV is acquired much more rapidly among new injector populations than previously recognized, demonstrating the need for early behavioral intervention among new heroin-user populations. Particularly critical are interventions that target new heroin user populations, including interventions that improve understanding of viral transmission dynamics, that promote alternative strategies for drug sharing, and that delay initiation of injection. 

Keywords  Hepatitis C prevalence - HCV incidence - Onset and initiation of heroin injection - IDU's - Harm reduction - Vietnam 

  _____  


Contact Information

Michael C. Clatts
Email: michael.clatts at upr.edu


 

 

 

 

 

 

 

Peter Higgs

NHMRC Post doctoral fellow

Viral Hepatitis Epidemiology & Prevention Program

National Centre in HIV Epidemiology & Clinical Research

University of NSW

AUSTRALIA

+ 61 (0) 421 030 456

 

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