Hepatitis C Testing and Undiagnosed Infections among People Injecting Image and Performance Enhancing Drugs in England & Wales: 2012-15.

Author: Hope VD, McVeigh J, Smith J, Glass R, Njoroge J, Tanner C, Parry JV, Ncube F

Theme: Epidemiology & Public Health Research Year: 2016


Hope VD1, McVeigh J2, Smith J3, Glass R1, Njoroge J1, Tanner C1, Parry JV1, Ncube F1.

National Infection Service, Public Health England, UK

Centre for Public Health, Liverpool John Moores University, UK

Public Health Wales, UK

Introduction: People injecting image & performance enhancing drugs (IPEDs) had been perceived as not being at high risk of hepatitis C virus (HCV) infection. However, recent studies indicate the HCV antibody (anti-HCV) prevalence in this group is 10 times that in the general population, but lower than among those injecting psychoactive drugs. HCV testing uptake and the extent of undiagnosed infection are examined using data from a voluntary unlinked-anonymous survey of people injecting IPEDs.

Methods: Survey participants completed a short questionnaire and provided a dried-blood spot sample. Data from two survey waves was used; second wave participants reporting participation in the first were excluded. Anti-HCV status and self-reports of HCV testing were used in the analysis.

Results: The anti-HCV prevalence was 4.8% (N=564; median age 31 years; 2% women; 14% had also injected psychoactive drugs). Among those who had never injected psychoactive drugs the anti-HCV prevalence was 1.4%; among those who had recently injected psychoactive drugs (preceding 12 months) prevalence was 39% and among those who had done this previously 14% (p<0.001). Overall, 37% had been tested for HCV: among those who had recently injected psychoactive drugs 78% had been tested, as had 56% of those who had done this previously; 33% of those never injecting psychoactive drugs were tested (p<0.001). Overall, 44% of those with anti-HCV were aware of this: 50% of those who had recently injected psychoactive drugs, 67% of those who had previously done this, and 14% of those who had never injected psychoactive drugs were aware. Two-fifths (6/15) of those unaware had never injected a psychoactive drug. Conclusion: Anti-HCV is common among people injecting IPEDs. HCV infections among those who had never injected psychoactive drugs were mostly undiagnosed, though this group had a lower prevalence. Targeted HCV testing interventions are needed for those only injecting IPEDs. Disclosure of Interest Statement: This work was core funded by Public Health England, and its delivery is supported by Public Health Wales and Centre for Public Health at Liverpool John Moores University. No pharmaceutical or other grants were received in the development or implementation of this study. No conflicts of interest.

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