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Risk for HCV infection greater with heroin use than prescription opioids
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Heroin injection increases the risk for hepatitis C infection more than the injection of prescription opioids among at-risk youth, according to data presented at the Society for Adolescent Health and Medicine Annual Meeting.
Researchers evaluated data from 940 drug users aged 14 to 26 years, collected from the At Risk Youth Study in Vancouver, Canada, between September 2005 and November 2011. All participants had used a drug other than marijuana within 1 month of enrollment, and received testing for HCV antibody and responded to a survey semiannually.
HCV antibody positivity was observed in 10.6% of the cohort at baseline. Ninety-four percent of participants reported having injected heroin, while 28% indicated having injected prescription opioids, including fentanyl, hydromorphone, meperidine, methadone, morphine or oxycodone.
Participants tested negative for HCV antibody at baseline in 54.4% of cases, and these patients received prospective HCV testing. Seroconversion to HCV positivity occurred in 10.9% of cases, with a calculated incidence rate of 6.5 per 100 person-years.
Investigators observed associations between risk for HCV seroconversion and injection of prescription opioids (HR=3.48; 95% CI, 1.57-7.70) and heroin (HR=9.89; 95% CI, 5.72-17.1) via Cox regression analysis. After adjusting for confounders, only the association with heroin use remained significant (HR=6.68; 95% CI, 3.58-12.5 for heroin; HR=0.67; 95% CI, 0.29-1.56 for prescription opioids).
“This study is among the first to report that heroin rather than prescription opioid injection remains the primary risk factor for HCV acquisition among at-risk youth,” the researchers concluded. “Although misuse of prescription opioids is on the rise in North America, traditional risk factors continue to pose the greatest threat of HCV acquisition.”
For more information:
Hadland SE. #P2: Risk of Hepatitis C Among Heroin and Prescription Opioid-Injecting Youth. Presented at: Society for Adolescent Health and Medicine 2013 Annual Meeting; March 13-16, Atlanta.