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|Seth Kuranz, Ruchika Sharma and Michael Hughes|
|Decision Resources Group, USA|
|ScientificTracks Abstracts: J Liver|
|Introduction: In developed countries, persons who inject drugs (PWIDs) are at highest risk of contracting HCV. In the US, persons who ever injected drugs had almost 30 times the risk of a positive HCV antibody test. Although incidence and prevalence of HCV is decreasing in the developed countries, access to care among the PWID population limits even greater reductions in the incidence of HCV. This, in addition to increasing rates of IDU in the US, means PWIDs are an important population for prevention and clinical intervention. Methods: The National Health and Nutrition Examination Survey (NHANES) is a nationally representative study of the noninstitutionalized US population. We used NHANES 1999-2010 to assess the prevalence of PWIDs among adults with viremic HCV. We also used the national death index, linked to NHANES by the NCHS, to examine mortality in this population using a Cox Proportional Hazards model. Results: The prevalence of PWIDs with viremic HCV between 1999 and 2010 in the US was 2.6 per 1.000 persons. By 2010, 9.1% of PWIDs with HCV were assumed to be deceased. Injecting drugs among the viremic HCV population in the US was associated with an increased rate of mortality [HR: 2.5 (95% CI: 1.8, 3.7)], adjusting for age and gender. Conclusion: There is excess mortality among the PWID/HCV population in the US. Since 2010, mortality rates have climbed due to both opiate prescribing practices, and the introduction of fentanyl into the illicit opioid drug market. Although PWIDs have a higher risk of both HCV and mortality, adherence to DAAs is similar in PWID and non-PWID populations, suggesting interventions are effective. These results will be discussed in the broader context of HCV epidemiology in the US and Europe.|
Seth Kuranz is an Epidemiologist at DRG specializing in Epidemiology of Metabolic, Renal and Psychiatric Disorders. He holds an MPH (Master of Public Health) degree from Boston University. He previously served as the Coordinator of an international research project focusing on early adult development and substance abuse dependence.
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