Hepatitis C Viremia and Genotype Distribution among a sample of HCV-exposed Nonmedical Prescription Drug Users in Rural Appalachia

Details

• Alternative Title:
  J Med Virol
• Personal Author:
  Young, April M. ; Crosby, Richard A. ; Oser, Carrie B. ; Leukefeld, Carl G. ; Stephens, Dustin B. ; Havens, Jennifer R.
• Description:
  Research has demonstrated that hepatitis C (HCV) genotype distribution varies geographically and demographically. This exploratory study examines HCV viremia, viral concentration, and genotype distribution among anti-HCV positive, rural Appalachian nonmedical prescription drug users. The study population was randomly selected from a pool of 200 anti-HCV positive participants in a longitudinal study. Those randomly chosen were representative of the overall pool in terms of demographics, drug use, and other risk behaviors. Participants were tested serologically for HCV RNA, viral concentration, and genotype, and interview-administered questionnaires examined behavioral and demographic characteristics. Of the 81 participants, 69% tested RNA positive, 59% of which had viral loads exceeding 800,000 IU/ml. Approximately 66% of the RNA positive sample had genotype 1a; types 2b (16%) and 3a (13%) were less common. RNA positive participants were not significantly different than RNA negative participants demographically or behaviorally. Likewise, with the exception of education, genotype 1 participants were not significantly different than those with genotype 2 or 3. The prevalence of active HCV infection highlights a need for prevention and treatment in this population. However, the predominance of genotype 1 may present challenges due to its association with decreased responsiveness to drug treatment, although the novel class of direct-acting antivirals such as telaprevir and boceprevir offer new hope in this regard. The prevalence of genotype 1 may also foreshadow heightened burden of hepatocellular carcinoma and elevated healthcare expenditures. More research is needed to characterize HCV infection and genotype in this population.
• Subjects:
  Adult Appalachian Region Drug Users Female Genotype Hepacivirus Hepatitis C Humans Kentucky Male Middle Aged Needle Sharing Opioid-Related Disorders Prevalence RNA, Viral Rural Population Viremia

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• Keywords:
  Genotype Hepatitis C Virus Injection Drug Use Rural
• Source:
  J Med Virol. 84(9):1376-1387
• Pubmed ID:
  22825816
• Pubmed Central ID:
  PMC3571688
• Document Type:
  Journal Article
• Funding:
  UL1 TR000117/TR/NCATS NIH HHSUnited States/ ; R01 DA024598/DA/NIDA NIH HHSUnited States/ ; K01DA021309/DA/NIDA NIH HHSUnited States/ ; TL1 TR000115/TR/NCATS NIH HHSUnited States/ ; 1U48DP001932-01/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP001932/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001998/TR/NCATS NIH HHSUnited States/ ; K01 DA021309/DA/NIDA NIH HHSUnited States/ ; R01DA024598/DA/NIDA NIH HHSUnited States/
• Volume:
  84
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:542c0c6039b52e939d709eb07997cc3c2dd9e5f5a88d5b24b2530d0bd76e4ab7
• Download URL:
  https://stacks.cdc.gov/view/cdc/33516/cdc_33516_DS1.pdf
• File Type:
  [PDF - 426.79 KB ]