title: [Incidence and risk factors of HCV infection in a cohort of intravenous drug users in the North and East of France].
abstract: BACKGROUND
  In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among intravenous drug users we conducted a prospective cohort study of HCV and HIV negative IVDU in the North and East of France.
  
  
  METHODS
  Two hundred and thirty-one IVDU who had injected drug at least once in their lifetime and were negative for anti-HCV and anti-HIV were followed-up every three months over a 12-month period. Serum anti-HCV and anti-HIV antibodies were tested at inclusion in the study and at the end of the follow-up. Data on injection practices and behaviours were collected at inclusion and at each visit, and a test for anti-HCV antibodies was performed on a saliva sample. When this proved positive, an ELISA test for serum anti-HCV antibodies was carried out.
  
  
  RESULTS
  Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9% (95% CI: 4.6-13.4) person-years for HCV infection. Among IVDU who injected at least once during the last 6 months HCV infection incidence was 11% (95% CI: 4.7-17.1) person-years. The multivariate analysis carried out on the inclusion data found female sex alone to be an independent predictive factor of HCV seroconversion. In a Cox proportional hazard multivariate analysis that took into account time-dependent exposures and covariates, we found that syringe and cotton sharing were, after adjusting for other covariates, the only independent predictive factors of HCV seroconversion: hazard ratio: 6.3 [corrected] (95% CI: 1.1-35.4; [corrected] p<0.05) and 16.4 (95% CI: 1.4-190.6; [corrected] p<0.05), respectively.
  
  
  CONCLUSIONS
  The transmission of the HCV virus persists among French IVDU despite an ongoing national harm reduction program. Injecting material and cotton sharing are the two major determinants of transmission in this cohort.
authors.affiliation: Institut de Veille Sanitaire, Saint-Maurice.
authors.forename: A
authors.initials: A
authors.lastname: Bruandet
authors.forename: D
authors.initials: D
authors.lastname: Lucidarme
authors.forename: A
authors.initials: A
authors.lastname: Decoster
authors.forename: D
authors.initials: D
authors.lastname: Ilef
authors.forename: J
authors.initials: J
authors.lastname: Harbonnier
authors.forename: C
authors.initials: C
authors.lastname: Jacob
authors.forename: C
authors.initials: C
authors.lastname: Delamare
authors.forename: C
authors.initials: C
authors.lastname: Cyran
authors.forename: A F
authors.initials: AF
authors.lastname: Van Hoenacker
authors.forename: D
authors.initials: D
authors.lastname: Frémaux
authors.forename: P
authors.initials: P
authors.lastname: Josse
authors.forename: J
authors.initials: J
authors.lastname: Emmanuelli
authors.forename: Y
authors.initials: Y
authors.lastname: Le Strat
authors.forename: B
authors.initials: B
authors.lastname: Filoche
authors.forename: J C
authors.initials: JC
authors.lastname: Desenclos
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015483:HIV Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012463:Saliva / Q000276:immunology; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000914:Antibodies, Viral; D015483:HIV Antibodies; D018937:Hepatitis C Antibodies