BACKGROUND: Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. METHODS: During 2008-2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCV infection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. RESULTS: Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95% CI 0.10-1.00, p=0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95% CI 0.001-1.07, p=0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95% CI 0.12-0.97, p=0.043; AOR 0.48, 95% CI 0.16-1.48, p=0.203). CONCLUSION: We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.
BACKGROUND: Prevalence of the hepatitis C virus (HCV) among people who inject drugs (PWID) in Scotland is high. The Scottish Government has invested significantly in harm reduction interventions with the goal of reducing HCV transmission among PWID. In evaluating the effectiveness of interventions, estimates of HCV incidence are essential. METHODS: During 2008-2009, PWID were recruited from services providing sterile injecting equipment across mainland Scotland, completed an interviewer-administered questionnaire and provided a dried blood spot for anonymous anti-HCV and HCV-RNA testing. Recent infections were defined as anti-HCV negative and HCV-RNA positive. Logistic regression was undertaken to examine associations between recent HCVinfection and self-reported uptake of methadone maintenance therapy (MMT) and injection equipment. RESULTS: Fifty-four percent (1367/2555) of participants were anti-HCV positive. We detected 24 recent HCV infections, yielding incidence rate estimates ranging from 10.8 to 21.9 per 100 person-years. After adjustment for confounders, those with high needle/syringe coverage had reduced odds of recent infection (adjusted odds ratio [AOR] 0.32, 95% CI 0.10-1.00, p=0.050). In the Greater Glasgow & Clyde region only, we observed a reduced odds of recent infection among those currently receiving MMT, relative to those on MMT in the last six months but not currently (AOR 0.04, 95% CI 0.001-1.07, p=0.055). The effect of combined uptake of MMT and high needle/syringe coverage was only significant in unadjusted analyses (OR 0.34, 95% CI 0.12-0.97, p=0.043; AOR 0.48, 95% CI 0.16-1.48, p=0.203). CONCLUSION: We report the first large-scale, national application of a novel method designed to determine incidence of HCV among PWID using a cross-sectional design. Subsequent sweeps of this survey will increase statistical power and allow us to gauge the impact of preventive interventions.
Authors: M Martinello; J Grebely; K Petoumenos; E Gane; M Hellard; D Shaw; J Sasadeusz; T L Applegate; G J Dore; G V Matthews Journal: J Viral Hepat Date: 2017-01-23 Impact factor: 3.728
Authors: Joanne Csete; Adeeba Kamarulzaman; Michel Kazatchkine; Frederick Altice; Marek Balicki; Julia Buxton; Javier Cepeda; Megan Comfort; Eric Goosby; João Goulão; Carl Hart; Thomas Kerr; Alejandro Madrazo Lajous; Stephen Lewis; Natasha Martin; Daniel Mejía; Adriana Camacho; David Mathieson; Isidore Obot; Adeolu Ogunrombi; Susan Sherman; Jack Stone; Nandini Vallath; Peter Vickerman; Tomáš Zábranský; Chris Beyrer Journal: Lancet Date: 2016-03-24 Impact factor: 79.321
Authors: Frederick L Altice; Lyuba Azbel; Jack Stone; Ellen Brooks-Pollock; Pavlo Smyrnov; Sergii Dvoriak; Faye S Taxman; Nabila El-Bassel; Natasha K Martin; Robert Booth; Heino Stöver; Kate Dolan; Peter Vickerman Journal: Lancet Date: 2016-07-14 Impact factor: 79.321
Authors: Nick Scott; Emma McBryde; Peter Vickerman; Natasha K Martin; Jack Stone; Heidi Drummer; Margaret Hellard Journal: BMC Med Date: 2015-08-20 Impact factor: 8.775
Authors: Natasha K Martin; Peter Vickerman; Jason Grebely; Margaret Hellard; Sharon J Hutchinson; Viviane D Lima; Graham R Foster; John F Dillon; David J Goldberg; Gregory J Dore; Matthew Hickman Journal: Hepatology Date: 2013-08-26 Impact factor: 17.425