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PLoS One. 2014 Jul 7;9(7):e100749. doi: 10.1371/journal.pone.0100749. eCollection 2014.

Per-event probability of hepatitis C infection during sharing of injecting equipment.

Author information

1
Inflammation and Infection Research Centre, School of Medical Sciences, The University of New South Wales, Sydney, Australia; Section of Immunology, School of Medicine, Imperial College, London, United Kingdom.
2
Inflammation and Infection Research Centre, School of Medical Sciences, The University of New South Wales, Sydney, Australia.
3
The Kirby Institute, The University of New South Wales, Sydney, Australia.
4
National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia.

Abstract

BACKGROUND:

Shared injecting apparatus during drug use is the premier risk factor for hepatitis C virus (HCV) transmission.

AIMS:

To estimate the per-event probability of HCV infection during a sharing event, and the transmission probability of HCV from contaminated injecting apparatus.

METHODS:

Estimates were obtained using a maximum likelihood method with estimated IDU and sharing events obtained from behavioural data.

SETTINGS:

Cohort study in multiple correction centres in New South Wales, Australia.

PARTICIPANTS:

Subjects (Nā€Š=ā€Š500) with a lifetime history of injecting drug use (IDU) who were followed up between 2005 and 2012. During follow-up, interviews for risk behaviours were taken and blood sampling (HCV-antibody and RNA testing) was performed.

MEASUREMENTS:

Self-reported frequencies of injecting drugs and sharing events, as well as other risk behaviours and details on the nature of injecting events.

FINDINGS:

The best estimate of the per-event probability of infection was 0.57% (CI: 0.32-1.05%). A sensitivity analysis on the likely effect of under-reporting of sharing of the injecting apparatus indicated that the per event infection probability may be as low as 0.17% (95% CI: 0.11%-0.25%). The transmission probability was similarly shown to range up to 6%, dependent on the presumed prevalence of the virus in injecting equipment.

CONCLUSIONS:

The transmission probability of HCV during a sharing event is small. Hence, strategies to reduce the frequency and sharing of injecting equipment are required, as well as interventions focused on decreasing the per event risk.

PMID:
25000496
PMCID:
PMC4085033
DOI:
10.1371/journal.pone.0100749
[Indexed for MEDLINE]
Free PMC Article

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