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Hepatitis C virus (HCV) prevalence, and injecting risk behaviour in multiple sites in England in 2004
Author(s) -
Hickman M.,
Hope V.,
Brady T.,
Madden P.,
Jones S.,
Honor S.,
Holloway G.,
Ncube F.,
Parry J.
Publication year - 2007
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2007.00855.x
Subject(s) - medicine , hepatitis c , syringe , demography , hepatitis c virus , odds ratio , odds , imprisonment , drug injection , immunology , human immunodeficiency virus (hiv) , logistic regression , virus , psychiatry , psychology , criminology , sociology
Summary. We sought to corroborate geographical differences in hepatitis C virus (HCV) prevalence and assess whether these can be explained by differences in injecting risk behaviour. A community recruited interview survey of 1058 injecting drug users (IDU) – including a blood spot specimen for antibody testing – was undertaken in seven cities in England. HCV prevalence varied from 27% to 74% across sites ( χ 2 (6) = 115.3, P < 0.001). There was a significant variation in crack‐injection, prison history, injecting frequency, homelessness, groin injecting, syringe reuse and sharing between the sites. Adjustment for clustering by site and other covariates attenuated the odds ratios (OR) for most variables: e.g. crack injection changed from an unadjusted OR of >2 to an adjusted OR of 1.4 (95% CI 0.9–2.0). Remaining significant covariates included: homelessness (OR 2.2; 1.4–3.6); ever imprisonment (OR 1.7; 1.2–2.5); syringe sharing >18 months ago (OR 2.0; 1.3–3.0); injecting duration and age. Introducing site as a second level variable did not reach significance ( P = 0.10). HCV prevalence among IDU reporting ‘never sharing’ was 48%. Geographical variation in HCV prevalence remains poorly explained, but should be the key focus of our surveillance effort. Measures of sharing and their interpretation require greater scrutiny.