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Reduction in HCV Incidence Among Injection Drug Users Attending Needle and Syringe Programs in Australia: a Linkage Study

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Specialty Public Health
Date 2013 Jun 15
PMID 23763399
Citations 27
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Abstract

Objectives: We examined trends in HCV incident infection among injection drug users (IDUs) attending needle and syringe programs (NSPs) in Australia in 1995 to 2010.

Methods: We created a passive retrospective cohort of 724 IDUs who tested negative for HCV antibodies by a simple deterministic method linking partial identifiers to find repeat respondents in annual cross-sectional serosurveillance.

Results: We identified 180 HCV seroconversions over the study period, for a pooled incidence density of 17.0 per 100 person-years (95% confidence interval [CI] = 14.68, 19.66). Incidence density declined, from a high of 30.8 per 100 person-years (95% CI = 21.3, 44.6) in 2003 to a low of 4.0 (95% CI = 1.3, 12.3) in 2009.

Conclusions: A decline in HCV incidence among Australian IDUs attending NSPs coincided with considerable expansion of harm reduction programs and a likely reduction in the number of IDUs, associated with significant changes in drug markets. Our results demonstrate the capacity of repeat cross-sectional serosurveillance to monitor trends in HCV incidence and provide a platform from which to assess the impact of prevention and treatment interventions.

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