Application of a novel method to estimate incidence of hepatitis C among injecting drug users in Scotland

Norah Palmateer, Elizabeth Allen, Avril Taylor, Sharon Hutchinson, David Goldberg

Research output: Contribution to journalArticle

Abstract

Background Prevalence of the hepatitis C virus (HCV) among injecting drug users (IDUs) in Scotland is high. Through an HCV Action Plan, the Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among IDUs. In evaluating the effectiveness of interventions, estimates of the incidence, rather than the prevalence, of HCV are essential. The traditional approach to measuring incidence—follow-up of a cohort of uninfected individuals to measure seroconversion—can, however, be costly and suffer high participant attrition rates. We report the first large-scale, national application of a novel method designed to determine incidence of HCV using a cross-sectional design.

Methods During 2008–2009, IDUs were recruited from needle exchange services, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous HCV-antibody (anti-HCV) and HCV-RNA testing. Incident infections were defined as individuals who were anti-HCV negative and HCV-RNA positive.

Results Prevalence of anti-HCV was 55% among the 2563 participants. Among anti-HCV negative respondents, twenty-one were HCV-RNA positive, yielding an incidence estimate of 12.1 per 100 person-years (corresponding to a viraemic pre-seroconversion window period of 51 days). Individuals currently receiving methadone had lower odds of incident infection (adjusted OR 0.15; 95% CI 0.035 to 0.68) relative to those on methadone in the previous 6 months (but not currently).

Conclusions This approach to measuring incidence will allow us to gauge the impact of preventive interventions associated with the HCV Action Plan.
Original languageUndefined/Unknown
Pages (from-to)A79
Number of pages1
JournalJournal of Epidemiology and Community Health
Volume65
Issue numberSupplement 1
DOIs
Publication statusPublished - 2011

Keywords

  • IDU
  • preventative interventions
  • hepatitus C
  • Scotland
  • epidemiology

Cite this

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title = "Application of a novel method to estimate incidence of hepatitis C among injecting drug users in Scotland",
abstract = "Background Prevalence of the hepatitis C virus (HCV) among injecting drug users (IDUs) in Scotland is high. Through an HCV Action Plan, the Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among IDUs. In evaluating the effectiveness of interventions, estimates of the incidence, rather than the prevalence, of HCV are essential. The traditional approach to measuring incidence—follow-up of a cohort of uninfected individuals to measure seroconversion—can, however, be costly and suffer high participant attrition rates. We report the first large-scale, national application of a novel method designed to determine incidence of HCV using a cross-sectional design.Methods During 2008–2009, IDUs were recruited from needle exchange services, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous HCV-antibody (anti-HCV) and HCV-RNA testing. Incident infections were defined as individuals who were anti-HCV negative and HCV-RNA positive.Results Prevalence of anti-HCV was 55{\%} among the 2563 participants. Among anti-HCV negative respondents, twenty-one were HCV-RNA positive, yielding an incidence estimate of 12.1 per 100 person-years (corresponding to a viraemic pre-seroconversion window period of 51 days). Individuals currently receiving methadone had lower odds of incident infection (adjusted OR 0.15; 95{\%} CI 0.035 to 0.68) relative to those on methadone in the previous 6 months (but not currently).Conclusions This approach to measuring incidence will allow us to gauge the impact of preventive interventions associated with the HCV Action Plan.",
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Application of a novel method to estimate incidence of hepatitis C among injecting drug users in Scotland. / Palmateer, Norah; Allen, Elizabeth; Taylor, Avril; Hutchinson, Sharon; Goldberg, David.

In: Journal of Epidemiology and Community Health, Vol. 65, No. Supplement 1, 2011, p. A79.

Research output: Contribution to journalArticle

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T1 - Application of a novel method to estimate incidence of hepatitis C among injecting drug users in Scotland

AU - Palmateer, Norah

AU - Allen, Elizabeth

AU - Taylor, Avril

AU - Hutchinson, Sharon

AU - Goldberg, David

PY - 2011

Y1 - 2011

N2 - Background Prevalence of the hepatitis C virus (HCV) among injecting drug users (IDUs) in Scotland is high. Through an HCV Action Plan, the Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among IDUs. In evaluating the effectiveness of interventions, estimates of the incidence, rather than the prevalence, of HCV are essential. The traditional approach to measuring incidence—follow-up of a cohort of uninfected individuals to measure seroconversion—can, however, be costly and suffer high participant attrition rates. We report the first large-scale, national application of a novel method designed to determine incidence of HCV using a cross-sectional design.Methods During 2008–2009, IDUs were recruited from needle exchange services, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous HCV-antibody (anti-HCV) and HCV-RNA testing. Incident infections were defined as individuals who were anti-HCV negative and HCV-RNA positive.Results Prevalence of anti-HCV was 55% among the 2563 participants. Among anti-HCV negative respondents, twenty-one were HCV-RNA positive, yielding an incidence estimate of 12.1 per 100 person-years (corresponding to a viraemic pre-seroconversion window period of 51 days). Individuals currently receiving methadone had lower odds of incident infection (adjusted OR 0.15; 95% CI 0.035 to 0.68) relative to those on methadone in the previous 6 months (but not currently).Conclusions This approach to measuring incidence will allow us to gauge the impact of preventive interventions associated with the HCV Action Plan.

AB - Background Prevalence of the hepatitis C virus (HCV) among injecting drug users (IDUs) in Scotland is high. Through an HCV Action Plan, the Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among IDUs. In evaluating the effectiveness of interventions, estimates of the incidence, rather than the prevalence, of HCV are essential. The traditional approach to measuring incidence—follow-up of a cohort of uninfected individuals to measure seroconversion—can, however, be costly and suffer high participant attrition rates. We report the first large-scale, national application of a novel method designed to determine incidence of HCV using a cross-sectional design.Methods During 2008–2009, IDUs were recruited from needle exchange services, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous HCV-antibody (anti-HCV) and HCV-RNA testing. Incident infections were defined as individuals who were anti-HCV negative and HCV-RNA positive.Results Prevalence of anti-HCV was 55% among the 2563 participants. Among anti-HCV negative respondents, twenty-one were HCV-RNA positive, yielding an incidence estimate of 12.1 per 100 person-years (corresponding to a viraemic pre-seroconversion window period of 51 days). Individuals currently receiving methadone had lower odds of incident infection (adjusted OR 0.15; 95% CI 0.035 to 0.68) relative to those on methadone in the previous 6 months (but not currently).Conclusions This approach to measuring incidence will allow us to gauge the impact of preventive interventions associated with the HCV Action Plan.

KW - IDU

KW - preventative interventions

KW - hepatitus C

KW - Scotland

KW - epidemiology

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JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

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