Per-Event Probability of Hepatitis C Infection during Sharing of Injecting Equipment |
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Authors: | Lies Boelen Suzy Teutsch David P Wilson Kate Dolan Greg J Dore Andrew R Lloyd Fabio Luciani on behalf of the HITS investigators |
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Institution: | 1. Inflammation and Infection Research Centre, School of Medical Sciences, The University of New South Wales, Sydney, Australia.; 2. The Kirby Institute, The University of New South Wales, Sydney, Australia.; 3. Section of Immunology, School of Medicine, Imperial College, London, United Kingdom.; 4. National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia.; University of Sydney, Australia, |
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Abstract: | BackgroundShared injecting apparatus during drug use is the premier risk factor for hepatitis C virus (HCV) transmission.AimsTo estimate the per-event probability of HCV infection during a sharing event, and the transmission probability of HCV from contaminated injecting apparatus.MethodsEstimates were obtained using a maximum likelihood method with estimated IDU and sharing events obtained from behavioural data.SettingsCohort study in multiple correction centres in New South Wales, AustraliaParticipantsSubjects (N = 500) with a lifetime history of injecting drug use (IDU) who were followed up between 2005 and 2012. During follow-up, interviews for risk behaviours were taken and blood sampling (HCV-antibody and RNA testing) was performed.MeasurementsSelf-reported frequencies of injecting drugs and sharing events, as well as other risk behaviours and details on the nature of injecting events.FindingsThe best estimate of the per-event probability of infection was 0.57% (CI: 0.32–1.05%). A sensitivity analysis on the likely effect of under-reporting of sharing of the injecting apparatus indicated that the per event infection probability may be as low as 0.17% (95% CI: 0.11%–0.25%). The transmission probability was similarly shown to range up to 6%, dependent on the presumed prevalence of the virus in injecting equipment.ConclusionsThe transmission probability of HCV during a sharing event is small. Hence, strategies to reduce the frequency and sharing of injecting equipment are required, as well as interventions focused on decreasing the per event risk. |
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