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15 June 2008

Volume 46, Number 12
Clinical Infectious Diseases 2008;46:1852–1858
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4612-0007$15.00
DOI: 10.1086/588297
MAJOR ARTICLE

Prevalence of Hepatitis C Virus Infection among Injection Drug Users in the United States, 1994–2004

Joseph J. Amon,1,a

Richard S. Garfein,2,3

Linda Ahdieh‐Grant,2

Gregory L. Armstrong,1

Lawrence J. Ouellet,6

Mary H. Latka,7,a

David Vlahov,7

Steffanie A. Strathdee,3

Sharon M. Hudson,4

Peter Kerndt,5

Don Des Jarlais,8 and

Ian T. Williams1

Divisions of 1Viral Hepatitis and 2HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia; 3Department of Family and Preventive Medicine, University of California–San Diego, School of Medicine, San Diego, 4Health Research Association, Hollywood, and 5Los Angeles County Department of Public Health, Los Angeles, California; 6Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago; 7New York Academy of Medicine, and 8Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center, New York, New York

Objective.To examine hepatitis C virus (HCV) seroprevalence among injection drug users in 4 US cities from 1994 through 2004.

Methods.Demographic characteristics, behaviors, and prevalence of HCV antibody among 5088 injection drug users aged 18–40 years from Baltimore, Maryland; Chicago, Illinois; Los Angeles, California; and New York, New York, enrolled in 3 related studies—Collaborative Injection Drug User Study (CIDUS) I (1994–1996), CIDUS II (1997–1999), and CIDUS III/Drug User Intervention Trial (2002–2004)—were compared using the χ2 and Mantel‐Haenszel tests of significance. Trends over time were assessed by logistic regression.

Results.Prevalence of HCV infection was 65%, 35%, and 35% in CIDUS I, CIDUS II, and CIDUS III, respectively. The adjusted prevalence odds ratio (OR) of being HCV antibody positive increased with the number of years of injection drug use (OR, 1.93 [95% confidence interval {CI}, 1.68–2.21] for each year of injecting within the first 2 years; OR, 1.09 [95% CI, 1.07–1.11] for each year of injecting beyond the first 2 years). Significant decreases were observed in the prevalence of HCV antibody between CIDUS I and CIDUS III in Baltimore (OR, 0.30; 95% CI, 0.20–0.43) and Los Angeles (OR, 0.17; 95% CI, 0.09–0.31) and among people of races other than black in Chicago (OR, 0.12; 95% CI, 0.08–0.17). No decrease in prevalence was seen in New York (OR, 1.04; 95% CI, 0.69–1.58) or among blacks in Chicago (OR, 0.55; 95% CI, 0.16–1.90).

Conclusion.Although regional differences exist, our data suggest that the incidence of HCV infection among injection drug users in the United States decreased from 1994 through 2004.

Received 1 October 2007; accepted 9 February 2008; electronically published 5 May 2008.

Reprints or correspondence: Dr. Joseph J. Amon, HIV/AIDS Program, Human Rights Watch, 350 Fifth Ave., 34th Fl., New York, NY 10118‐3299 ().

Cited by

M. J. Sweeting, V. D. Hope, M. Hickman, J. V. Parry, F. Ncube, M. E. Ramsay, D. De Angelis. (2009) Hepatitis C Infection Among Injecting Drug Users in England and Wales (1992-2006): There and Back Again?. American Journal of Epidemiology
Online publication date: 22-Jul-2009.
CrossRef
A. John-Baptiste, M. Varenbut, M. Lingley, T. Nedd-Roderique, D. Teplin, G. Tomlinson, J. Daiter, M. Krahn. (2009) Treatment of hepatitis C infection for current or former substance abusers in a community setting. Journal of Viral Hepatitis
Online publication date: 1-Mar-2009.
CrossRef
H. Hagan, E. R. Pouget, D. C. Des Jarlais, C. Lelutiu-Weinberger. (2008) Meta-Regression of Hepatitis C Virus Infection in Relation to Time Since Onset of Illicit Drug Injection: The Influence of Time and Place. American Journal of Epidemiology 168:10, 1099-1109
Online publication date: 9-Nov-2008.
CrossRef

  • The views expressed in this article are those of the authors and do not reflect the official policy or position of the Centers for Disease Control and Prevention or other institutions with which the authors are affiliated.

  • Present affiliations: HIV/AIDS Program, Human Rights Watch, New York, New York (J.J.A.); Aurum Institute for Health Research, Johannesburg, South Africa (M.H.L.).

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