WEPE489 - Poster Exhibition
Prevalence of HCV-HIV co-infection and risk factors for HCV among injecting drug users in northeast India
G.K. Medhi1, J. Mahanta2, S. Phukan3, R. Paranjape4, G. Thongamba5
1Regional Medical Research Centre, NE Region, HIV/AIDS and Drug Abuse, Dibrugarh, India, 2Regional Medical Research Centre, ICMR, NE Region, Dibrugarh, India, 3Regional Medical Research Centre, Dibrugarh, India, 4National AIDS Research Institute (NARI), Pune, India, 5FHI 360, New Delhi, India
Background: HCV infection has several serious health consequences on its own, and co-infection with HIV may be associated with more severe adverse clinical outcomes. Injecting drug use is a serious public health problem in northeast India and is the main driver of its ongoing HIV epidemic. Understanding risk factors of HCV and burden of HCV-HIV co-infection among IDUs will help designing appropriated HCV prevention strategy and knowing treatment and care need for HCV-HIV co-infected persons. We, therefore, aim to assess prevalence of HCV-HIV co-infection and risk factors of HCV among IDUs in the region.
Methods: A total of 1648 IDUs from two northeastern states (Manipur/Nagaland) was recruited into the Integrated Biological and Behavioural Assessment (IBBA) survey (2009) using respondent driven sampling, collected demographic/behavioural data using anonymous questionnaire, and blood samples were tested for HIV and HCV using ELISA test. Factors independently associated with HCV seropositivity were identified using multivariate regression analysis.
Results: Sero-prevalence of HCV and HCV-HIV co-infection was 43.9% and 15% respectively. Among 264 HIV seropositive (16%), 248 (93.9%) had HCV co-infection. Sharing of drug solution from common container (81.6%), other drug injecting paraphernalia such as dropper/cotton etc (75.2%), and needles/syringes (NS) previously used by others (61.9%) was very common. Nearly 24% reported having sex with paying female partners and 27.2% had sex with casual non-paying female partners. Inconsistent condom use was high with paying female sex partners (58.7%) and non-paying casual sex partners (80.4%). Factors independently associated with HCV seropositivity were: being a manual laborer (AOR: 2.08), ≥6 yeas of injecting career (AOR: 5.81), sharing drug injecting paraphernalia (AOR: 1.6), using NS previously used by others (AOR: 1.8), injecting drugs at least once in a day (AOR: 4.34), sex with paying female partners (AOR: 2.18), inconsistent condom use with paying female sex partner (AOR: 1.6).
Conclusion: More than 90% of HIV positives had HCV co-infection. Vulnerability to HCV was associated with frequency of drug injections, direct sharing of NS, sharing of drug injecting paraphernalia, and sexual risk behaviours. Urgent strategy to reduce both injection and sexual risk behaviours is warranted to contain HCV epidemic among IDUs.
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