Injecting frequency trajectories and hepatitis C virus acquisition: Findings from a cohort of people who inject drugs in Montréal, Canada
| Autor: | Emmanuel Fortier, Andreea Adelina Artenie, Jason Grebely, Stine Bordier Høj, Didier Jutras-Aswad, Marie-Pierre Sylvestre, Julie Bruneau, Nanor Minoyan |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Canada medicine.medical_specialty Hepatitis C virus 030508 substance abuse Medicine (miscellaneous) Hepacivirus medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Substance Abuse Intravenous Hepatitis business.industry Health Policy Incidence (epidemiology) Trajectory group Hepatitis C medicine.disease 3. Good health Pharmaceutical Preparations Cohort Female 0305 other medical science business Clearance Cohort study |
| Zdroj: | International Journal of Drug Policy. 96:103439 |
| ISSN: | 0955-3959 |
| Popis: | Background Frequent injecting increases hepatitis C (HCV) acquisition risk among people who inject drugs (PWID). However, few studies have examined how temporal fluctuations in injecting frequency may effect HCV infection risk. Thus, this study examined HCV incidence according to injecting frequency trajectories followed by PWID over one year in Montreal, Canada. Methods At three-month intervals from March 2011 to June 2016, HCV-uninfected PWID (never infected or cleared infection) enrolled in the Hepatitis Cohort (HEPCO) completed interviewer-administered questionnaires and HCV testing. At each visit, participants reported the number of injecting days (0–30 days) for each of the past three months. In previous work, using group-based trajectory modeling, we identified five injecting frequency trajectories followed by participants over one year (months 1–12 of follow-up), including sporadic, infrequent, increasing, decreasing, and frequent injecting. In this study, we estimated group-specific HCV incidence (months 1–63 of follow-up) using posterior probabilities to assign participants to their most likely trajectory group. Results Of 386 participants (mean age=40, 82% male, 48% never HCV-infected), 72 acquired HCV during 893 person-years of follow-up. HCV incidence for the whole study sample was 8.1 per 100 person-years (95%CI=6.4–10.1). Trajectory group-specific HCV incidences were highest for those injecting drugs with decreasing (23.9, 14.4–37.5) or increasing frequency (16.0, 10.1–24.3), intermediate for those injecting at consistently high frequency (10.2, 5.4–17.8), and lowest for those injecting infrequently (3.9, 2.2–6.5) or sporadically (4.3, 2.2–7.6). Conclusion Results suggest that PWID at highest HCV risk are those injecting at high frequency, either transitorily (increasing, decreasing injecting) or consistently (frequent injecting). This study highlights changes in injecting frequency as a potentially important dimension to consider among the factors leading to HCV acquisition. Clinical and public health interventions tailored to PWID with different injecting frequency profiles may contribute to HCV prevention. |
| Databáze: | OpenAIRE |
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