Baseline Characteristics of An Urban Cohort of Patients with Chronic HCV and Active IDU: Challenges and Possibilities

Author: Kattakuzhy S, Hill K, Sidique N, Gross C, Silk R, Akoth E, Sternberg D, Masur H, Kottilil S, Rosenthal ES

Theme: Epidemiology & Public Health Research Year: 2017

Introduction: People with active injection drug use and chronic hepatitis C (HCV)
represent a high-risk population, both due to their marginalized status, as well as their
ongoing risk of HCV transmission. Given their infrequent interaction with the health care
system, little is known about the baseline characteristics and risk behaviors of active
PWID with HCV.
Methods: The ANCHOR investigation is an ongoing, single-center study of
comprehensive HCV treatment in an urban cohort of active PWID, set in a harm
reduction drop-in facility. Patients included in this analysis completed a comprehensive
screening assessment, had detectable HCV RNA, and reported injection of opioids
within three months.
Results: Of 43 patients analyzed, participants were predominantly male (34, 79%),
middle-aged (median 57 years), and black race (40, 93%). Majority of patients reported
income from the government (23,53%), or no consistent income (18,41%). All patients
reported prior incarceration. Nearly half of patients (19,44.2%) noted no regular provider
visit in the last year, with transportation (13,30%) noted as the major barrier to receiving
The median age of first injection was 27 years. 34(79%) patients reported injecting
opioids one or more times daily, and most used a new needle with every injection (30,
69.8%). 37(86.0%) had experience with opioid replacement therapy. 30 patients
(69.8%) reported previous opioid overdose (average 3.7 times), 40(93%) had witnessed
an overdose, but only 17(39.5%) had administered naloxone.
Conclusions: In an urban cohort of PWID with HCV, there was a high degree of social
instability, with limited income, frequent incarceration, and irregular medical care.
Simultaneously there was high frequency of injection and overdose, and limited
experience with overdose reversal agents, supporting the public health need for
interventions within this high-risk population. Co-location of social, medical, and drug
treatment services may reduce barriers to target the specific needs of this marginalized
Disclosure of interest statement ANCHOR study was supported by an investigator
initiated grant from Gilead paid to the institution (IHV/UMD)

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