Hepatitis C virus (HCV) prevalence, and injecting risk behaviour in multiple sites in England in 2004

M. Hickman*, V. Hope, T. Brady, P. Madden, S. Jones, S. Honor, G. Holloway, Fortune Ncube, John Parry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

85 Citations (Scopus)


We sought to corroborate geographical differences in hepatitis C virus (HCV) prevalence and assess whether these can be explained by differences in injecting risk behaviour. A community recruited interview survey of 1058 injecting drug users (IDU) - including a blood spot specimen for antibody testing - was undertaken in seven cities in England. HCV prevalence varied from 27% to 74% across sites (χ2(6) = 115.3, P < 0.001). There was a significant variation in crack-injection, prison history, injecting frequency, homelessness, groin injecting, syringe reuse and sharing between the sites. Adjustment for clustering by site and other covariates attenuated the odds ratios (OR) for most variables: e.g. crack injection changed from an unadjusted OR of >2 to an adjusted OR of 1.4 (95% CI 0.9-2.0). Remaining significant covariates included: homelessness (OR 2.2; 1.4-3.6); ever imprisonment (OR 1.7; 1.2-2.5); syringe sharing >18 months ago (OR 2.0; 1.3-3.0); injecting duration and age. Introducing site as a second level variable did not reach significance (P = 0.10). HCV prevalence among IDU reporting 'never sharing' was 48%. Geographical variation in HCV prevalence remains poorly explained, but should be the key focus of our surveillance effort. Measures of sharing and their interpretation require greater scrutiny.

Original languageEnglish
Pages (from-to)645-652
Number of pages8
JournalJournal of Viral Hepatitis
Issue number9
Publication statusPublished - Sept 2007


  • Behavioural surveillance
  • Epidemiology
  • Hepatitis C virus
  • Injecting drug use


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