Epidemiology

Injection drug use tied to hepatitis C in HIV patients

Last Updated: 2005-08-17 17:13:36 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Injection drug use appears to be the leading cause of hepatitis C virus (HCV) infection in patients with HIV, Swiss researchers report in the August issue of Clinical Infectious Diseases.

"The continuing high incidence in injection drug users," senior investigator Dr. Hansjakob Furrer told Reuters Health, "is disappointing because it reflects our inability to reach this population sufficiently, even in a country with a high standard of needle exchange and substitution programs."

To investigate the relative roles of injection drug use and unsafe sex in spreading HCV, Dr. Furrer of University Hospital Berne and colleagues studied data on 7889 HIV patients. Between 1998 and 2004, the seroprevalence of HCV was 33%. However, it was 90% in those reporting injection drug use.

The overall HCV incidence was estimated to be 0.64 cases per 100 person-years. In participants with a history of injection drug use, the incidence was 7.4 cases per 100 person-years compared to 0.23 cases per 100 person-years in those without such a history.

In men who had sex with men (MSM) who had no history of injection drug use but who did report unsafe sex, the incidence was 0.7 cases per 100 person-years. In men who did not report unsafe sex, the incidence was 0.3 per 100 person years.

"Although the individual risk is rather small," Dr. Furrer concluded, "our findings give additional reason to motivate MSM to practice safe sex even in relationships among HIV-positive partners."

Clin Infect Dis 2005;41:395-402.