Hepatitis C virus (HCV) prevalence, and injecting risk behaviour in multiple sites in England in 2004

J Viral Hepat. 2007 Sep;14(9):645-52. doi: 10.1111/j.1365-2893.2007.00855.x.


We sought to corroborate geographical differences in hepatitis C virus (HCV) prevalence and assess whether these can be explained by differences in injecting risk behaviour. A community recruited interview survey of 1058 injecting drug users (IDU) - including a blood spot specimen for antibody testing - was undertaken in seven cities in England. HCV prevalence varied from 27% to 74% across sites (chi(2)(6) = 115.3, P < 0.001). There was a significant variation in crack-injection, prison history, injecting frequency, homelessness, groin injecting, syringe reuse and sharing between the sites. Adjustment for clustering by site and other covariates attenuated the odds ratios (OR) for most variables: e.g. crack injection changed from an unadjusted OR of >2 to an adjusted OR of 1.4 (95% CI 0.9-2.0). Remaining significant covariates included: homelessness (OR 2.2; 1.4-3.6); ever imprisonment (OR 1.7; 1.2-2.5); syringe sharing >18 months ago (OR 2.0; 1.3-3.0); injecting duration and age. Introducing site as a second level variable did not reach significance (P = 0.10). HCV prevalence among IDU reporting 'never sharing' was 48%. Geographical variation in HCV prevalence remains poorly explained, but should be the key focus of our surveillance effort. Measures of sharing and their interpretation require greater scrutiny.

MeSH terms

  • Adult
  • Demography
  • Disease Transmission, Infectious
  • England / epidemiology
  • Female
  • Hepatitis C / complications
  • Hepatitis C / epidemiology*
  • Humans
  • Male
  • Prevalence
  • Risk Factors
  • Risk-Taking
  • Substance Abuse, Intravenous / complications
  • Substance Abuse, Intravenous / epidemiology*
  • Surveys and Questionnaires