Recent Syringe Sharing, Long Injecting History, Past Incarceration and Not Living with the Family are Independently Associated with Hepatitis C Virus (HCV) Infection among People who Inject Drugs (PWID) in Greece

Author: Anagnostou O, Fotiou A, Kanavou E, Andaraki A, Richardson C, Micha K, Kafetzopoulos E and Terzidou M, OKANA Medical Doctors Group

Theme: Epidemiology & Public Health Research Year: 2015

The prevalence of hepatitis C virus (HCV) infection among people who inject drugs (PWID) is high in Greece. HCV infection may lead to severe chronic liver disease and premature death, and also places a burden on the treatment system. Unsafe injecting is the main route for HCV transmission, but other factors may increase infection risks. This study examines the factors associated with HCV infection among PWID entering opioid substitution treatment (OST) in Greece.
Anonymous serological and behavioural data were available for 563 people (80% male, 95% Greek) who entered OST in central and southern Greece in 2013 and reported recent injecting drug use. The outcome measure was the presence of HCV antibodies. The correlates comprised sociodemographic (gender, age, living with family and/or partner with children, homelessness, imprisonment etc.), drug use (number of substances used, frequency of use etc.) and high-risk behavioural characteristics (injecting history, sharing syringes and other paraphernalia, etc).
HCV infection was detected in 79.4% of the cases. Multivariate logistic regression analyses adjusting for gender and age showed independent associations between HCV infection and long injecting histories (odds ratio [OR] = 3.9, 95% confidence interval [CI]: 1.4-11.0, for injecting histories of 5 to 9 years, and OR = 8.4, 95% CI: 3.1-22.2, for injecting histories of ≥10 years, both p < 0.001), ever being imprisoned (OR = 2.5, 95% CI: 1.6-4.0, p < 0.001), recent sharing of syringes (OR = 2.8, 95% CI: 1.5-5.1, p = 0.001) and not living with parents and/or a partner plus children (OR = 2.0, 95% CI: 1.1-3.4, p = 0.015). Conclusion: The scaling-up of both OST and needle/syringe programs in the community and in prisons may reduce HCV infection vulnerabilities among PWID in Greece. Further investigation of the association of family status with HCV infection is needed.

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