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Abstract

Background

Monitoring hepatitis C virus (HCV) incidence is important for assessing intervention impact. Longitudinal studies of people who inject drugs (PWID), using repeated biological tests, are costly; alternatively, incidence can be estimated using biological markers of recent infection in cross-sectional studies.

Aim

We aimed to compare incidence estimates obtained from two different biological markers of recent infection in a cross-sectional study to inform monitoring approaches for HCV elimination strategies.

Method

Samples from an unlinked anonymous bio-behavioural survey of PWID were tested for two recent infection markers: HCV RNA with anti-HCV negative (‘RNA’) and low-avidity anti-HCV with HCV RNA present (‘avidity’). These two markers were used separately and in combination to estimate HCV incidence.

Results

Between 2011 and 2013, 2,816 anti-HIV-negative PWID (25% female) who had injected during the preceding year were either HCV-negative or had one of the two markers of recent infection: 57 (2.0%) had the RNA marker and 90 (3.2%) the avidity marker. The two markers had similar distributions of risk and demographic factors. Pooled estimated incidence was 12.3 per 100 person-years (pyrs) (95% credible interval: 8.8–17.0) and not significantly different to avidity-only (p = 0.865) and RNA-only (p = 0.691) estimates. However, the RNA marker is limited by its short duration before anti-HCV seroconversion and the avidity marker by uncertainty around its duration.

Conclusion

Both markers have utility in monitoring HCV incidence among PWID. When HCV transmission is high, one marker may provide an accurate estimate of incidence; when it is low or decreasing, a combination may be required.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2018.23.47.1700635
2018-11-22
2024-12-03
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.47.1700635
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A comparison of two biological markers of recent hepatitis C virus (HCV) infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Vivian+D+Hope&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hope Vivian D</a>, <a href="/search?value1=Ross+J+Harris&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Harris Ross J</a>, <a href="/search?value1=Peter+Vickerman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vickerman Peter</a>, <a href="/search?value1=Lucy+Platt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Platt Lucy</a>, <a href="/search?value1=Justin+Shute&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Shute Justin</a>, <a href="/search?value1=Katelyn+J+Cullen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cullen Katelyn J</a>, <a href="/search?value1=Samreen+Ijaz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ijaz Samreen</a>, <a href="/search?value1=Sema+Mandal&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mandal Sema</a>, <a href="/search?value1=Fortune+Ncube&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ncube Fortune</a>, <a href="/search?value1=Monica+Desai&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Desai Monica</a>, <a href="/search?value1=John+V+Parry&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Parry John V</a></span>. A comparison of two biological markers of recent hepatitis C virus (HCV) infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(47):pii=1700635. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.47.1700635" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.47.1700635</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 14 Sept 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 15 May 2018 </span> </p>
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