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A comparison of two biological markers of recent HCV infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs.

Hope, VD, Harris, RJ, Vickerman, P, Platt, L, Shute, J, Cullen, KJ, Ijaz, S, Mandal, S, Ncube, F, Desai, M and Parry, JV (2018) A comparison of two biological markers of recent HCV infection: implications for the monitoring of interventions and strategies to reduce HCV transmission among people who inject drugs. Eurosurveillance, 23 (47). ISSN 1560-7917

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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.

Item Type: Article
Subjects: Q Science > QH Natural history > QH301 Biology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and Teaching. Research
Divisions: Public Health Institute
Publisher: European Centre for DIsease Prevention and Control
Date Deposited: 23 Nov 2018 10:51
Last Modified: 23 Nov 2018 17:30
DOI or Identification number: 10.2807/1560-7917.ES.2018.23.47.1700635
URI: http://researchonline.ljmu.ac.uk/id/eprint/8703

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