Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy
So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007–2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundr...
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| Veröffentlicht in: | Journal of urban health 2018-02, Vol.95 (1), p.99-110 |
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| creator | Spada, Enea Rezza, Giovanni Garbuglia, Anna Rosa Lombardo, Flavia Lucia Zuccaro, Ornella Menniti Ippolito, Francesca Cupellaro, Elisabetta Capone, Stefania Capobianchi, Maria Rosaria Nicosia, Alfredo Cortese, Riccardo Folgori, Antonella Mele, Alfonso |
| description | So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007–2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis. Participants were mostly male (83.4%), under opioid substitution therapy (OST) (78.9%), non-injecting DUs (67.9%), and with a mean age of 30.8. Ninety-one of 224 DUs initially under OST interrupted treatment during the follow-up. Overall HCV incidence was 5.83/100 person-years at risk (PYAR) [95% confidence intervals (CI), 3.63–9.38]. The incidence did not significantly differ according the participants’ sociodemographic characteristics or the degree of urbanization of the towns involved in the study. The incidence was higher for DUs under than for those not under OST (6.23 vs 4.50/100 PYAR;
p
= 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR;
p
= 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed. |
| doi_str_mv | 10.1007/s11524-017-0207-5 |
| format | Article |
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p
= 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR;
p
= 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed.</description><identifier>ISSN: 1099-3460</identifier><identifier>EISSN: 1468-2869</identifier><identifier>DOI: 10.1007/s11524-017-0207-5</identifier><identifier>PMID: 29204843</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Antiviral agents ; Confidence intervals ; Drug abuse ; Epidemiology ; Health Informatics ; Hepatitis ; Hepatitis C ; Incidence ; Injection ; Intravenous administration ; Medicine ; Medicine & Public Health ; Opioids ; Public Health ; Ribonucleic acid ; Risk analysis ; Risk factors ; RNA ; Seroconversion ; Urban areas ; Urbanization ; Viruses</subject><ispartof>Journal of urban health, 2018-02, Vol.95 (1), p.99-110</ispartof><rights>The New York Academy of Medicine 2017</rights><rights>Journal of Urban Health is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-2716c4a4a1ab4503445ffc63645b328e80bb4ca6e89b340ba0cade2e4168659f3</citedby><cites>FETCH-LOGICAL-c470t-2716c4a4a1ab4503445ffc63645b328e80bb4ca6e89b340ba0cade2e4168659f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11524-017-0207-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11524-017-0207-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29204843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spada, Enea</creatorcontrib><creatorcontrib>Rezza, Giovanni</creatorcontrib><creatorcontrib>Garbuglia, Anna Rosa</creatorcontrib><creatorcontrib>Lombardo, Flavia Lucia</creatorcontrib><creatorcontrib>Zuccaro, Ornella</creatorcontrib><creatorcontrib>Menniti Ippolito, Francesca</creatorcontrib><creatorcontrib>Cupellaro, Elisabetta</creatorcontrib><creatorcontrib>Capone, Stefania</creatorcontrib><creatorcontrib>Capobianchi, Maria Rosaria</creatorcontrib><creatorcontrib>Nicosia, Alfredo</creatorcontrib><creatorcontrib>Cortese, Riccardo</creatorcontrib><creatorcontrib>Folgori, Antonella</creatorcontrib><creatorcontrib>Mele, Alfonso</creatorcontrib><creatorcontrib>Collaborative Study Group</creatorcontrib><creatorcontrib>The Collaborative Study Group</creatorcontrib><title>Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy</title><title>Journal of urban health</title><addtitle>J Urban Health</addtitle><addtitle>J Urban Health</addtitle><description>So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007–2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis. Participants were mostly male (83.4%), under opioid substitution therapy (OST) (78.9%), non-injecting DUs (67.9%), and with a mean age of 30.8. Ninety-one of 224 DUs initially under OST interrupted treatment during the follow-up. Overall HCV incidence was 5.83/100 person-years at risk (PYAR) [95% confidence intervals (CI), 3.63–9.38]. The incidence did not significantly differ according the participants’ sociodemographic characteristics or the degree of urbanization of the towns involved in the study. The incidence was higher for DUs under than for those not under OST (6.23 vs 4.50/100 PYAR;
p
= 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR;
p
= 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed.</description><subject>Antiviral agents</subject><subject>Confidence intervals</subject><subject>Drug abuse</subject><subject>Epidemiology</subject><subject>Health Informatics</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Incidence</subject><subject>Injection</subject><subject>Intravenous administration</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Opioids</subject><subject>Public Health</subject><subject>Ribonucleic acid</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>RNA</subject><subject>Seroconversion</subject><subject>Urban areas</subject><subject>Urbanization</subject><subject>Viruses</subject><issn>1099-3460</issn><issn>1468-2869</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kV9rFTEQxYMotlY_gC8S8MWXtZM_m82-CHK1dqEglNYnIWRzZ6-pe5NrkhX67c3l1lILPmVgfudkZg4hrxm8ZwDdaWas5bIB1jXAoWvaJ-SYSaUbrlX_tNbQ942QCo7Ii5xvAJiSHX9OjnjPQWopjsn3ITi_xuCQ2rCmlz7_pGfWlZgynWKi57izxRef6Yp-82nJdAgTuuJjoHYbw4YO8-ydL_RTWjb0OmMV-kCHYufbl-TZZOeMr-7eE3J99vlqdd5cfP0yrD5eNE52UBreMeWklZbZUbYgpGynySmhZDsKrlHDOEpnFep-FBJGC86ukaNkSqu2n8QJ-XDw3S3jFtcOQ0l2Nrvktzbdmmi9-bcT_A-zib9NqxVXvaoG7-4MUvy1YC5m67PDebYB45IN6ztRLywEq-jbR-hNXFKo6-0pzjjoTlSKHSiXYs4Jp_thGJh9duaQnanZmX12pq2aNw-3uFf8DasC_ADk2gobTA--_q_rH1YGo_M</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Spada, 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Elisabetta ; Capone, Stefania ; Capobianchi, Maria Rosaria ; Nicosia, Alfredo ; Cortese, Riccardo ; Folgori, Antonella ; Mele, Alfonso</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-2716c4a4a1ab4503445ffc63645b328e80bb4ca6e89b340ba0cade2e4168659f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antiviral agents</topic><topic>Confidence intervals</topic><topic>Drug abuse</topic><topic>Epidemiology</topic><topic>Health Informatics</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Incidence</topic><topic>Injection</topic><topic>Intravenous administration</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Opioids</topic><topic>Public Health</topic><topic>Ribonucleic acid</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>RNA</topic><topic>Seroconversion</topic><topic>Urban 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Participant titles)</collection><jtitle>Journal of urban health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spada, Enea</au><au>Rezza, Giovanni</au><au>Garbuglia, Anna Rosa</au><au>Lombardo, Flavia Lucia</au><au>Zuccaro, Ornella</au><au>Menniti Ippolito, Francesca</au><au>Cupellaro, Elisabetta</au><au>Capone, Stefania</au><au>Capobianchi, Maria Rosaria</au><au>Nicosia, Alfredo</au><au>Cortese, Riccardo</au><au>Folgori, Antonella</au><au>Mele, Alfonso</au><aucorp>Collaborative Study Group</aucorp><aucorp>The Collaborative Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy</atitle><jtitle>Journal of urban health</jtitle><stitle>J Urban Health</stitle><addtitle>J Urban Health</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>95</volume><issue>1</issue><spage>99</spage><epage>110</epage><pages>99-110</pages><issn>1099-3460</issn><eissn>1468-2869</eissn><abstract>So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007–2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis. Participants were mostly male (83.4%), under opioid substitution therapy (OST) (78.9%), non-injecting DUs (67.9%), and with a mean age of 30.8. Ninety-one of 224 DUs initially under OST interrupted treatment during the follow-up. Overall HCV incidence was 5.83/100 person-years at risk (PYAR) [95% confidence intervals (CI), 3.63–9.38]. The incidence did not significantly differ according the participants’ sociodemographic characteristics or the degree of urbanization of the towns involved in the study. The incidence was higher for DUs under than for those not under OST (6.23 vs 4.50/100 PYAR;
p
= 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR;
p
= 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29204843</pmid><doi>10.1007/s11524-017-0207-5</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antiviral agents Confidence intervals Drug abuse Epidemiology Health Informatics Hepatitis Hepatitis C Incidence Injection Intravenous administration Medicine Medicine & Public Health Opioids Public Health Ribonucleic acid Risk analysis Risk factors RNA Seroconversion Urban areas Urbanization Viruses |
| title | Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy |
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