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Minimal transmission of HIV despite persistently high transmission of hepatitis C virus in a Swedish needle exchange program.

ALANKO BLOMÉ, MARIANNE LU ; Björkman, Per LU ; Flamholc, Leo LU ; Jacobsson, Helene; Molnegren, Vilma and Widell, Anders LU (2011) In Journal of Viral Hepatitis 18. p.831-839
Abstract
Summary. The aim of this study was to examine the prevalence and incidence of HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish needle exchange programme (NEP) and to identify risk factors for blood-borne transmission. A series of serum samples from NEP participants enrolled from 1997 to 2005 were tested for markers of HIV, HBV and HCV (including retrospective testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV seroconverter). Prevalence and incidence were correlated with self-reported baseline characteristics. Among 831 participants available for follow-up, one was HIV positive at baseline and two seroconverted to anti-HIV during the follow-up of 2433 HIV-negative person-years... (More)
Summary. The aim of this study was to examine the prevalence and incidence of HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish needle exchange programme (NEP) and to identify risk factors for blood-borne transmission. A series of serum samples from NEP participants enrolled from 1997 to 2005 were tested for markers of HIV, HBV and HCV (including retrospective testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV seroconverter). Prevalence and incidence were correlated with self-reported baseline characteristics. Among 831 participants available for follow-up, one was HIV positive at baseline and two seroconverted to anti-HIV during the follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering 1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993: 11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred mostly during the first year after NEP enrolment. Of the 332 cases testing anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion during follow-up was significantly associated with mixed injection use of amphetamine and heroin, and a history of incarceration at baseline. In this NEP setting, HIV prevalence and incidence remained low and HBV incidence declined because of vaccination, but transmission of HCV was persistently high. HCV RNA testing in anti-HCV-negative NEP participants led to more accurate identification of timepoints for transmission. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Viral Hepatitis
volume
18
pages
831 - 839
publisher
Wiley-Blackwell
external identifiers
  • wos:000297990200002
  • pmid:21114587
  • scopus:81555223024
ISSN
1365-2893
DOI
10.1111/j.1365-2893.2010.01400.x
language
English
LU publication?
yes
id
431c451c-2a1d-4d40-9bed-184a099eaf18 (old id 1757022)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21114587?dopt=Abstract
date added to LUP
2011-01-03 11:28:31
date last changed
2017-08-27 05:44:17
@article{431c451c-2a1d-4d40-9bed-184a099eaf18,
  abstract     = {Summary. The aim of this study was to examine the prevalence and incidence of HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish needle exchange programme (NEP) and to identify risk factors for blood-borne transmission. A series of serum samples from NEP participants enrolled from 1997 to 2005 were tested for markers of HIV, HBV and HCV (including retrospective testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV seroconverter). Prevalence and incidence were correlated with self-reported baseline characteristics. Among 831 participants available for follow-up, one was HIV positive at baseline and two seroconverted to anti-HIV during the follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering 1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993: 11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred mostly during the first year after NEP enrolment. Of the 332 cases testing anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion during follow-up was significantly associated with mixed injection use of amphetamine and heroin, and a history of incarceration at baseline. In this NEP setting, HIV prevalence and incidence remained low and HBV incidence declined because of vaccination, but transmission of HCV was persistently high. HCV RNA testing in anti-HCV-negative NEP participants led to more accurate identification of timepoints for transmission.},
  author       = {ALANKO BLOMÉ, MARIANNE and Björkman, Per and Flamholc, Leo and Jacobsson, Helene and Molnegren, Vilma and Widell, Anders},
  issn         = {1365-2893},
  language     = {eng},
  pages        = {831--839},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Viral Hepatitis},
  title        = {Minimal transmission of HIV despite persistently high transmission of hepatitis C virus in a Swedish needle exchange program.},
  url          = {http://dx.doi.org/10.1111/j.1365-2893.2010.01400.x},
  volume       = {18},
  year         = {2011},
}