Hepatitis C

Risk Factors for HCV Are Identified Among People Who Inject Drugs

Homelessness and unsafe injection practices may have contributed to hepatitis C virus (HCV) exposure, according to the results of recent study presented at IDWeek 2020.

The researchers conducted a cross-sectional study of 101 individuals who were hospitalized with an infection associated with injection drug use. The individuals were enrolled through 4 hospitals that had been identified as high-risk for HIV/HCV outbreaks in Maine. HCV exposure was determined through a self-report of exposure from the patients or a positive test for HCV antibodies.

Data was collected through the use of the Audio Computer-Assisted Self-Interview survey and a review of medical records. The use of safe injection practices was then measured by the Bacterial Infections Risk Scale for Injectors 7-item index (BIRSI-7).

Exposure to HCV was identified in 75% of the study participants (n = 76). Homelessness proved to be a risk factor of HCV exposure, as 57% of participants who were exposed to HCV experienced homelessness. In addition, 71% of participants exposed to HCV also reported infrequent use of alcohol pads prior to injecting drugs. Infrequent hand washing was also common, as reported in 67% of HCV-exposed participants. These individuals were also 25% more likely to have bacteremia during hospitalization.

Higher odds of exposure were seen in participants with higher BIRSI-7 scores. The participants who had not been exposed to HCV had a perceived low likelihood of being exposed through injection.

“The data obtained highlights significant relationships between HCV exposure and certain risk factors. Homelessness was found to be associated with HCV exposure, suggesting an opportunity for more targeted intervention within this subgroup of [people who inject drugs]. Unsafe injection practices as measured by the BIRSI-7 score were related to HCV exposure, indicating educational opportunities about safe injection practices. Overall, targeted harm reduction services could be beneficial in screening and prevention of HCV exposure amongst [people who inject drugs],” the researchers concluded.


—Leigh Precopio




Sankar N, Murray K, Burris DD, Thakarar K. Hepatitis C infection amongst people who inject drugs (PWID): injection practices and risk factors. Talk presented at: IDWeek 2020; October 21-25, 2020; Virtual.