Hepatitis C virus prevalence and estimated incidence among new injectors during the opioid epidemic in New York City, 2000–2017: Protective effects of non-injecting drug use

Don Des Jarlais, Kamyar Arasteh, J. Feelemyer, Courtney Mcknight, David Barnes, David C. Perlman, A. Uuskula, H. L.F. Cooper, Susan Tross

Research output: Contribution to journalArticle

Abstract

Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs. Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from persons entering Mount Sinai Beth Israel substance use treatment programs. A structured interview was administered and HCV antibody testing conducted. Protective effects of non-injecting drug use were examined among persons who “reversed transitioned” to non-injecting drug use and persons who used non-injected heroin in addition to injecting. Results: Participants were 79% male, 41% White, 15% African-American, 40% Latinx, with a mean age of 35. Of those who began injecting in 2000 or later, 97 persons (11%) “reverse transitioned” back to non-injecting drug use. Reverse transitioning was strongly associated with lower HCV seroprevalence (30% versus 47% among those who continued injecting, p < 0.005). Among those who continued injecting, HCV seropositivity was inversely associated with current non-injecting heroin use (AOR = 0.72, 95%CI 0.52-0.99). HCV incidence among persons continuing to inject was estimated as 13/100 person-years. HCV seropositive persons currently injecting cocaine were particularly likely to report behavior likely to transmit HCV. Conclusions: Similar to other locations in the US, NYC is experiencing high rates of HCV infection among persons who have begun injecting since 2000. New interventions that facilitate substitution of non-injecting for injecting drug use and that reduce transmission behavior among HCV seropositives may provide additional methods for reducing HCV transmission.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalDrug and Alcohol Dependence
Volume192
DOIs
StatePublished - Nov 1 2018

Fingerprint

Viruses
Hepacivirus
Opioid Analgesics
Incidence
Pharmaceutical Preparations
Heroin
Virus Diseases
Hepatitis C Antibodies
Seroepidemiologic Studies
Cocaine
Israel
African Americans
Substitution reactions
Interviews
Testing

Keywords

  • Hepatitis C
  • HIV
  • Opioid epidemic
  • Persons who inject drugs

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

@article{f5d0ddcff4074ca1bb02a79416bae18a,
title = "Hepatitis C virus prevalence and estimated incidence among new injectors during the opioid epidemic in New York City, 2000–2017: Protective effects of non-injecting drug use",
abstract = "Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs. Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from persons entering Mount Sinai Beth Israel substance use treatment programs. A structured interview was administered and HCV antibody testing conducted. Protective effects of non-injecting drug use were examined among persons who “reversed transitioned” to non-injecting drug use and persons who used non-injected heroin in addition to injecting. Results: Participants were 79{\%} male, 41{\%} White, 15{\%} African-American, 40{\%} Latinx, with a mean age of 35. Of those who began injecting in 2000 or later, 97 persons (11{\%}) “reverse transitioned” back to non-injecting drug use. Reverse transitioning was strongly associated with lower HCV seroprevalence (30{\%} versus 47{\%} among those who continued injecting, p < 0.005). Among those who continued injecting, HCV seropositivity was inversely associated with current non-injecting heroin use (AOR = 0.72, 95{\%}CI 0.52-0.99). HCV incidence among persons continuing to inject was estimated as 13/100 person-years. HCV seropositive persons currently injecting cocaine were particularly likely to report behavior likely to transmit HCV. Conclusions: Similar to other locations in the US, NYC is experiencing high rates of HCV infection among persons who have begun injecting since 2000. New interventions that facilitate substitution of non-injecting for injecting drug use and that reduce transmission behavior among HCV seropositives may provide additional methods for reducing HCV transmission.",
keywords = "Hepatitis C, HIV, Opioid epidemic, Persons who inject drugs",
author = "{Des Jarlais}, Don and Kamyar Arasteh and J. Feelemyer and Courtney Mcknight and David Barnes and Perlman, {David C.} and A. Uuskula and Cooper, {H. L.F.} and Susan Tross",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.drugalcdep.2018.07.034",
language = "English (US)",
volume = "192",
pages = "74--79",
journal = "Drug and Alcohol Dependence",
issn = "0376-8716",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Hepatitis C virus prevalence and estimated incidence among new injectors during the opioid epidemic in New York City, 2000–2017

T2 - Protective effects of non-injecting drug use

AU - Des Jarlais, Don

AU - Arasteh, Kamyar

AU - Feelemyer, J.

AU - Mcknight, Courtney

AU - Barnes, David

AU - Perlman, David C.

AU - Uuskula, A.

AU - Cooper, H. L.F.

AU - Tross, Susan

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs. Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from persons entering Mount Sinai Beth Israel substance use treatment programs. A structured interview was administered and HCV antibody testing conducted. Protective effects of non-injecting drug use were examined among persons who “reversed transitioned” to non-injecting drug use and persons who used non-injected heroin in addition to injecting. Results: Participants were 79% male, 41% White, 15% African-American, 40% Latinx, with a mean age of 35. Of those who began injecting in 2000 or later, 97 persons (11%) “reverse transitioned” back to non-injecting drug use. Reverse transitioning was strongly associated with lower HCV seroprevalence (30% versus 47% among those who continued injecting, p < 0.005). Among those who continued injecting, HCV seropositivity was inversely associated with current non-injecting heroin use (AOR = 0.72, 95%CI 0.52-0.99). HCV incidence among persons continuing to inject was estimated as 13/100 person-years. HCV seropositive persons currently injecting cocaine were particularly likely to report behavior likely to transmit HCV. Conclusions: Similar to other locations in the US, NYC is experiencing high rates of HCV infection among persons who have begun injecting since 2000. New interventions that facilitate substitution of non-injecting for injecting drug use and that reduce transmission behavior among HCV seropositives may provide additional methods for reducing HCV transmission.

AB - Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs. Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from persons entering Mount Sinai Beth Israel substance use treatment programs. A structured interview was administered and HCV antibody testing conducted. Protective effects of non-injecting drug use were examined among persons who “reversed transitioned” to non-injecting drug use and persons who used non-injected heroin in addition to injecting. Results: Participants were 79% male, 41% White, 15% African-American, 40% Latinx, with a mean age of 35. Of those who began injecting in 2000 or later, 97 persons (11%) “reverse transitioned” back to non-injecting drug use. Reverse transitioning was strongly associated with lower HCV seroprevalence (30% versus 47% among those who continued injecting, p < 0.005). Among those who continued injecting, HCV seropositivity was inversely associated with current non-injecting heroin use (AOR = 0.72, 95%CI 0.52-0.99). HCV incidence among persons continuing to inject was estimated as 13/100 person-years. HCV seropositive persons currently injecting cocaine were particularly likely to report behavior likely to transmit HCV. Conclusions: Similar to other locations in the US, NYC is experiencing high rates of HCV infection among persons who have begun injecting since 2000. New interventions that facilitate substitution of non-injecting for injecting drug use and that reduce transmission behavior among HCV seropositives may provide additional methods for reducing HCV transmission.

KW - Hepatitis C

KW - HIV

KW - Opioid epidemic

KW - Persons who inject drugs

UR - http://www.scopus.com/inward/record.url?scp=85053474581&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053474581&partnerID=8YFLogxK

U2 - 10.1016/j.drugalcdep.2018.07.034

DO - 10.1016/j.drugalcdep.2018.07.034

M3 - Article

C2 - 30243142

AN - SCOPUS:85053474581

VL - 192

SP - 74

EP - 79

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

ER -