Theme: Epidemiology & Public Health Research Year: 2016
HCV INFECTION AND HIV-HCV COINFECTION AMONG “NEW” INJECTORS
DURING AN HIV OUTBREAK IN ATHENS, GREECE: RESULTS FROM THE
ARISTOTLE PROGRAMME
Sypsa V
1
, Vickerman P
2
, Malliori M
3
, Hatzakis A
1
1 Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National
and Kapodistrian University of Athens, Athens, Greece
2 School of Social and Community Medicine, University of Bristol, Bristol, UK
3 Department of Psychiatry, School of Medicine, National and Kapodistrian University of
Athens, Athens, Greece
Background: ARISTOTLE programme was an intervention implemented during an HIV
outbreak among people who inject drugs (PWID) in Athens (2012-2013). Aim of this
analysis is to provide estimates of the prevalence and incidence of HCV infection and of
the prevalence of HIV-HCV coinfection among PWID injecting for up to 2 years (“new”
injectors).
Methods: Five rounds (A-E) of respondent driven sampling (RDS) were used to recruit
PWID. PWID could participate in multiple rounds but only once per round. Blood
samples were tested for anti-HIV-1/2. PWID reporting injecting drug use for 2 years
were also tested for anti-HCV. HCV incidence was estimated in two ways: i) using data
from all “new” injectors, assuming that they were seronegative when they started
injecting and that infection occurred in the midpoint between the initiation of injecting
and the time of blood sample collection, ii) using data from “new” injectors with multiple
participations who were seronegative at first participation and seroconverted during the
programme.
Results: During ARISTOTLE, 608 blood samples were collected from 431 “new”
injectors. At first participation, anti-HCV prevalence was 49.9% (95% Confidence
Interval [95% CI]:45.0%, 54.7%). Among 65 HIV-infected PWID, HCV prevalence was
92.3% (95% CI: 84.0%, 97.0%). The prevalence of HIV-HCV coinfection was 13.9%
(95% CI: 10.8%, 17.6%). HCV incidence was 77.3/100 person-years (95% CI: 63.1,
94.8) and 50.2/100 person-years (95% CI: 38.6-65.4) in rounds A and E, respectively.
Out of 63 HCV(-) “new” injectors with multiple blood samples, 16 seroconverted during
ARISTOTLE. Thus, HCV incidence was estimated to be 64.6/100 person-years (95%
CI: 39.6, 105.4).
Conclusion: The prevalence of HCV and HIV-HCV coinfection as well as the incidence
of HCV infection are very high in the population of “new” injectors in Athens.
Disclosure of Interest Statement: The ARISTOTLE programme was co-funded by the
European Social Fund and national resources. The authors have no conflict of interest
to disclose in connection with this presentation