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O09.5 Hepatitis C incidence rate among people who inject drug (PWID) in british columbia from 2000 to 2015
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  1. Yiqiao Li1,
  2. Stanley Wong2,
  3. Zahid Butt1,
  4. Carmine Rossi1,
  5. Jason Wong2,
  6. Amanda Yu2,
  7. Mawuena Binka2,
  8. Maria Alvarez1,
  9. Mel Krajden3,
  10. Naveed Janjua1
  1. 1British Columbia Center for Disease Control, Vancouver, Canada
  2. 2BC Centre for Disease Control, Clinical Prevention Services, Vancouver, Canada
  3. 3BC Centre for Disease Control, Public Health Laboratory, Vancouver, Canada

Abstract

Background Global Health Sector Strategy on Viral Hepatitis aims to reduce new hepatitis C virus (HCV) infections by 80% by 2030. However, countries lack systems to monitor incidence of HCV. We estimated the HCV incidence over time among people who inject drugs (PWID) at population level to provide proof of concept for incidence monitoring.

Methods This study utilized data from the BC Hepatitis Testers Cohort (BC-HTC). Incidence was defined as a positive anti-HCV, RNA, or genotype test following a negative anti-HCV test among PWID, assessed based on a previously validated algorithm using administrative data. Annual incidence rates for HCV primary infection from 2000 to 2015 were estimated using a log-binomial regression model and were stratified by birth cohorts (<1965, 1965–1974, >1974) to observe change in risk over time. Adjusted incidence rates (aIR) were calculated controlling for risk factors.

Results Of the 42,568 participants identified, 4,066 HCV seroconversions occurred over 318,613 person-years (PY) of follow-up. The overall incidence rate was 1.28/100PY. Between 2000 and 2011, the annual aIR decreased steadily from 4.01 to 1.00/100PY. The aIR then rose to 1.49/100PY in 2015. Factors associated with elevated risk of infection include: younger birth cohort (1965–1974: RR:1.9, 95%CI: 1.02,3.6), history of illicit opioid use (RR:2.5, 95%CI: 2.3,2.7), stimulant misuse (RR:1.77, 95%CI: 1.7,1.9), HIV coinfection (RR:3.6, 95%CI: 3.1,4.1), HBV coinfection (RR:1.9, 95%CI: 1.6,2.2), material deprivation (RR:1.5, 95%CI: 1.4,1.7) and social deprivation (RR:1.6, 95%CI: 1.4,1.8).

Conclusion A slight increase in HCV incidence rate since 2011 was mainly driven by the younger birth cohort and introduction of enhanced testing in 2010. People with HIV or HBV coinfection, opioid and stimulant misuse, social and material deprivation are at higher risk of HCV infection. HCV treatment and prevention programs need to address comorbidities and include harm reduction strategies like opioid substitution therapy and access to social services to achieve HCV elimination goals.

Disclosure No significant relationships.

  • hepatitis C
  • injection drug use

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