Ann Infect Dis Epidemiol | Volume 2, Issue 2 | Research Article | Open Access

Hepatitis C Incidence and Spontaneous Viral Clearance in a Cohort of Human Immunodeficiency Virus and Hepatitis B Virus Negative Drug Users

Dimpy P Shah¹, Carolyn Grimes¹, Dejian Lai² and Lu-Yu Hwang^1*

¹Department of Infectious Diseases, University of Texas–Health Science Center at Houston, USA
²Department of Biostatistics, University of Texas–Health Science Center at Houston, USA

^*Correspondance to: Lu-Yu Hwang 

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Abstract

Estimating HCV incidence and viral clearance in other than young, White, injection drug users (IDUs), negative for HBV and HIV has not been undertaken. We enrolled 1,260 mostly African American injecting and non-injecting drug users negative for HIV and HBV prospectively from urban areas in Houston, TX, from 2005-2009, to determine HCV incidence and spontaneous viral clearance. Socio demographic and high risk behavioral data and blood samples were collected every 6 months for two years. Serum was tested for antibodies to HCV by enzyme immunoassay (EIA), and confirmed for HCV RNA by polymerase chain reaction (PCR). Kaplan-Meier failure curves and Cox proportional hazard regression analyses were performed to identify factors for HCV incidence. A follow-up HCV RNA PCR test was used to determine viral clearance in HCV incident cases. We followed 840 anti-HCV negative participants resulting in 19 HCV seroconversions per 1436.67 person years for an HCV incidence of 13.2/1000 PY (95% Confidence Interval [CI], 8.4- 20.7). IDU’s risk of contracting HCV compared to non-injecting drug users (62.5 per 1000PY, 95% CI, 33.6-116.2, vs. 7.1 per 1000PY, 95% CI 3.7-13.6) was significantly higher. White/Hispanic race, injecting drugs at least daily, and being 40 years of age or older were significant risk factors for HCV seroconversion. Spontaneous viral clearance was observed in 42% of HCV incident cases. HCV incidence remains high among HB vaccinated drug users. Daily injecting drug use is a predictor for new HCV infection. An HCV vaccine is urgently needed, especially in high risk populations.

Keywords:

HCV; HIV; HBV; Substance abuse; Infection; Disparity

Citation:

Shah DP, Grimes C, Lai D, Hwang L-Y. Hepatitis C Incidence and Spontaneous Viral Clearance in a Cohort of Human Immunodeficiency Virus and Hepatitis B Virus Negative Drug Users. Ann Infect Dis Epidemiol. 2017;2(2):1014.