Risk behaviors and antibody hepatitis B and C prevalence among injecting drug users in south-western Sydney, Australia
Maher, L and Chant, K and Jalaludin, B and Sargent, PL, Risk behaviors and antibody hepatitis B and C prevalence among injecting drug users in south-western Sydney, Australia, Journal of Gastroenterology and Hepatology, 19, (10) pp. 1114-1120. ISSN 1440-1746 (2004) [Refereed Article]
Background and Aim: Hepatitis C virus (HCV) infection is now the leading notifiable disease in
Australia. The current study aimed to determine the prevalence of HCV and hepatitis B virus (HBV)
infection and associated risk behaviors among injecting drug users (IDUs) screened in south-western
Sydney as part of a multisite prospective cohort study.
Methods: Using a combination of snowball sampling and word-of-mouth recruitment strategies, 377
IDUs were interviewed using a structured questionnaire and tested for exposure to HCV and HBV.
Entry criteria were injecting drug use in the previous 6 months and antibody HCV serostatus not known
to be positive.
Results: More than one-third (36.6%) tested HCV antibody positive and one-quarter (28%) had been
exposed to HBV. Independent predictors of HCV seropositivity were HBV core antibody positive
serostatus, incarceration in the past year, injecting in public, Asian ethnicity and duration of injecting.
Individual risk behaviors, including sharing needles and syringes, sharing other injecting equipment and
being injected by others, were not significant in either bivariate or multivariate models.
Conclusions: Results indicate an urgent need for structural interventions designed to reduce the exposure
of IDUs, particularly indigenous Australian and Asian injectors, to risk environments. Structural
interventions, including population-based hepatitis B immunization, expanded access to needle and
syringe programs and drug treatment, prison diversion programs and medically supervised injecting
facilities, should be incorporated into existing blood-borne virus prevention efforts.
epidemiology, hepatitis, drug users, public health