Using hepatitis C virus and herpes simplex virus-2 to track HIV among injecting drug users in New York City.
OBJECTIVE
To explore the potential utility of hepatitis C virus (HCV) seroprevalence as a biomarker for injection risk, and herpes simplex virus-2 (HSV-2) as a biomarker for sexual risk among injecting drug users (IDUs). We examined the relationships between HCV and HIV and between HSV-2 and HIV among injecting drug users in New York City relative to the large-scale implementation of syringe exchange in the mid-1990s.


METHODS
397 injecting drug users were recruited from a drug detoxification program in New York from 2005 to 2007. Informed consent was obtained, a questionnaire covering demographics, drug use and HIV risk was administered. Blood samples were tested for antibody to HIV, HCV and HSV-2.


RESULTS
Among all subjects, HIV prevalence was 17%, HCV prevalence 72% and HSV-2 prevalence 48%. Among IDUs who began injecting before 1995, HIV was 28%, HCV serostatus was strongly associated with HIV serostatus (AOR=8.96, 95% CI 1.16-69.04) and HSV-2 serostatus was not associated with HIV serostatus (AOR=1.31, 95% CI 0.64-2.67). Among subjects who began injecting in 1995 or later, HIV was 6%, HCV was not associated with HIV (AOR=1.04, 95% CI 0.27-4.08) and HSV-2 serostatus was strongly related to HIV serostatus (AOR=10.71, 95% CI 1.18-97.57).


CONCLUSIONS
HCV and HSV-2 HCV and HSV-2 may provide important new tools for monitoring evolving HIV epidemics among IDUs. Reconsideration of the current CDC hierarchical transmission risk classification system may also be warranted.
Des Jarlais
Don C
DC
Beth Israel Medical Center, NewYork, NY 10038, USA. dcdesjarla@aol.com
Arasteh
Kamyar
K
McKnight
Courtney
C
Hagan
Holly
H
Perlman
David
D
Friedman
Samuel R
SR
D000328:Adult; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D015528:HIV Seroprevalence; D016174:Hepacivirus; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology*; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000821:virology*; D018258:Herpesvirus 2, Human; D006801:Humans; D008297:Male; D018671:Needle-Exchange Programs; D009519:New York City / Q000453:epidemiology; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*