IDUs decreased drug use after HCV seroconversion

Bruneau J. Clin Infect Dis. 2013;doi:10.1093/cid/cit938

  • December 30, 2013

Injection drug users who test positive for hepatitis C were more likely to decrease their drug use, according to researchers from the University of Montreal.

“Our study underscores the need for regular and individualized HCV screening and counseling for all [injection drug users] with linkage to HCV treatment and opiate substitution therapy when appropriate,” the researchers wrote in Clinical Infectious Diseases.

The researchers evaluated 208 injection drug users (IDUs) who were initially HCV-negative. The IDUs were followed prospectively between 2004 and 2011. They had semi-annual screening visits that including blood sampling and an interview questionnaire.

All of the individuals had at least three visits during the study period. Most of the participants were men, the median age was 31.8 years and the median duration of injection drug use was 8.2 years.

Among the 208 IDUs in the study, 69 individuals (33.2%) seroconverted to HCV, for an incidence rate of 14.4 per 100 person-years (95% CI, 11.3-18.1). Participants who seroconverted were more likely to report injecting cocaine or opioids, and to report sharing syringes. Among those who seroconverted, there was a significant decrease in risky behavior. The odds of subsequent drug injection decreased by 10% with each 3 months of follow-up.  There were no similar reductions in injection drug use among those who remained seronegative.

Both the seroconverters and the seronegative individuals reported decreases in sharing syringes, with a greater decrease among those who seroconverted. But there were no changes in alcohol use for either group.

“A new research agenda should aim at identifying…whether it is the impact of the result itself (new infection), the impact of intensified counseling, and support the reference for care, or a combination of all of these actions,” the researchers wrote. “Also, specific and possibly sustained intervention should be developed, studied and eventually implemented for those screened negative for HCV.”

Disclosure: The researchers report no relevant financial disclosures.