Minimal transmission of HIV despite persistently high transmission of hepatitis C virus in a Swedish needle exchange program.

[Guest guest]

J Viral Hepat. 2010 Nov 29. doi: 10.1111/j.1365-2893.2010.01400.x. [Epub ahead

of print]

Minimal transmission of HIV despite persistently high transmission of hepatitis

C virus in a Swedish needle exchange program.

Blomé MA, Björkman P, Flamholc L, sson H, Molnegren V, Widell A.

Department of Infectious Diseases, Division of Clinical Sciences, Lund

University, Malmö; Sweden Competence Centre for Clinical Research, Lund

University Hospital, Lund, Sweden Department of Medical Microbiology, Lund

University, Malmö University hospital, Malmö, Sweden.

Abstract

Summary.  The aim of this study was to examine the prevalence and incidence of

HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish

needle exchange programme (NEP) and to identify risk factors for blood-borne

transmission. A series of serum samples from NEP participants enrolled from 1997

to 2005 were tested for markers of HIV, HBV and HCV (including retrospective

testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV

seroconverter). Prevalence and incidence were correlated with self-reported

baseline characteristics. Among 831 participants available for follow-up, one

was HIV positive at baseline and two seroconverted to anti-HIV during the

follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years

at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering

1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993:

11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred

mostly during the first year after NEP enrolment. Of the 332 cases testing

anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same

baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion

during follow-up was significantly associated with mixed injection use of

amphetamine and heroin, and a history of incarceration at baseline. In this NEP

setting, HIV prevalence and incidence remained low and HBV incidence declined

because of vaccination, but transmission of HCV was persistently high. HCV RNA

testing in anti-HCV-negative NEP participants led to more accurate

identification of timepoints for transmission.

© 2010 Blackwell Publishing Ltd.

PMID: 21114587 [PubMed - as supplied by publisher]

[Guest guest]

J Viral Hepat. 2010 Nov 29. doi: 10.1111/j.1365-2893.2010.01400.x. [Epub ahead

of print]

Minimal transmission of HIV despite persistently high transmission of hepatitis

C virus in a Swedish needle exchange program.

Blomé MA, Björkman P, Flamholc L, sson H, Molnegren V, Widell A.

Department of Infectious Diseases, Division of Clinical Sciences, Lund

University, Malmö; Sweden Competence Centre for Clinical Research, Lund

University Hospital, Lund, Sweden Department of Medical Microbiology, Lund

University, Malmö University hospital, Malmö, Sweden.

Abstract

Summary.  The aim of this study was to examine the prevalence and incidence of

HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish

needle exchange programme (NEP) and to identify risk factors for blood-borne

transmission. A series of serum samples from NEP participants enrolled from 1997

to 2005 were tested for markers of HIV, HBV and HCV (including retrospective

testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV

seroconverter). Prevalence and incidence were correlated with self-reported

baseline characteristics. Among 831 participants available for follow-up, one

was HIV positive at baseline and two seroconverted to anti-HIV during the

follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years

at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering

1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993:

11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred

mostly during the first year after NEP enrolment. Of the 332 cases testing

anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same

baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion

during follow-up was significantly associated with mixed injection use of

amphetamine and heroin, and a history of incarceration at baseline. In this NEP

setting, HIV prevalence and incidence remained low and HBV incidence declined

because of vaccination, but transmission of HCV was persistently high. HCV RNA

testing in anti-HCV-negative NEP participants led to more accurate

identification of timepoints for transmission.

© 2010 Blackwell Publishing Ltd.

PMID: 21114587 [PubMed - as supplied by publisher]

[Guest guest]

J Viral Hepat. 2010 Nov 29. doi: 10.1111/j.1365-2893.2010.01400.x. [Epub ahead

of print]

Minimal transmission of HIV despite persistently high transmission of hepatitis

C virus in a Swedish needle exchange program.

Blomé MA, Björkman P, Flamholc L, sson H, Molnegren V, Widell A.

Department of Infectious Diseases, Division of Clinical Sciences, Lund

University, Malmö; Sweden Competence Centre for Clinical Research, Lund

University Hospital, Lund, Sweden Department of Medical Microbiology, Lund

University, Malmö University hospital, Malmö, Sweden.

Abstract

Summary.  The aim of this study was to examine the prevalence and incidence of

HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish

needle exchange programme (NEP) and to identify risk factors for blood-borne

transmission. A series of serum samples from NEP participants enrolled from 1997

to 2005 were tested for markers of HIV, HBV and HCV (including retrospective

testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV

seroconverter). Prevalence and incidence were correlated with self-reported

baseline characteristics. Among 831 participants available for follow-up, one

was HIV positive at baseline and two seroconverted to anti-HIV during the

follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years

at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering

1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993:

11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred

mostly during the first year after NEP enrolment. Of the 332 cases testing

anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same

baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion

during follow-up was significantly associated with mixed injection use of

amphetamine and heroin, and a history of incarceration at baseline. In this NEP

setting, HIV prevalence and incidence remained low and HBV incidence declined

because of vaccination, but transmission of HCV was persistently high. HCV RNA

testing in anti-HCV-negative NEP participants led to more accurate

identification of timepoints for transmission.

© 2010 Blackwell Publishing Ltd.

PMID: 21114587 [PubMed - as supplied by publisher]

[Guest guest]

J Viral Hepat. 2010 Nov 29. doi: 10.1111/j.1365-2893.2010.01400.x. [Epub ahead

of print]

Minimal transmission of HIV despite persistently high transmission of hepatitis

C virus in a Swedish needle exchange program.

Blomé MA, Björkman P, Flamholc L, sson H, Molnegren V, Widell A.

Department of Infectious Diseases, Division of Clinical Sciences, Lund

University, Malmö; Sweden Competence Centre for Clinical Research, Lund

University Hospital, Lund, Sweden Department of Medical Microbiology, Lund

University, Malmö University hospital, Malmö, Sweden.

Abstract

Summary.  The aim of this study was to examine the prevalence and incidence of

HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish

needle exchange programme (NEP) and to identify risk factors for blood-borne

transmission. A series of serum samples from NEP participants enrolled from 1997

to 2005 were tested for markers of HIV, HBV and HCV (including retrospective

testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV

seroconverter). Prevalence and incidence were correlated with self-reported

baseline characteristics. Among 831 participants available for follow-up, one

was HIV positive at baseline and two seroconverted to anti-HIV during the

follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years

at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering

1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993:

11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred

mostly during the first year after NEP enrolment. Of the 332 cases testing

anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same

baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion

during follow-up was significantly associated with mixed injection use of

amphetamine and heroin, and a history of incarceration at baseline. In this NEP

setting, HIV prevalence and incidence remained low and HBV incidence declined

because of vaccination, but transmission of HCV was persistently high. HCV RNA

testing in anti-HCV-negative NEP participants led to more accurate

identification of timepoints for transmission.

© 2010 Blackwell Publishing Ltd.

PMID: 21114587 [PubMed - as supplied by publisher]