The authors declare that they have no competing interests.
Hepatitis C viremia and genotype distribution among a sample of nonmedical prescription drug users exposed to HCV in rural Appalachia†
Article first published online: 18 JUL 2012
Copyright © 2012 Wiley Periodicals, Inc.
Journal of Medical Virology
Volume 84, Issue 9, pages 1376–1387, September 2012
How to Cite
Young, A. M., Crosby, R. A., Oser, C. B., Leukefeld, C. G., Stephens, D. B. and Havens, J. R. (2012), Hepatitis C viremia and genotype distribution among a sample of nonmedical prescription drug users exposed to HCV in rural Appalachia. J. Med. Virol., 84: 1376–1387. doi: 10.1002/jmv.23252
- Issue published online: 18 JUL 2012
- Article first published online: 18 JUL 2012
- Manuscript Accepted: 16 JAN 2012
- National Institute on Drug Abuse. Grant Number: R01DA024598
- Centers for Disease Control and Prevention. Grant Number: 1U48DP001932-01
- National Institute on Drug Abuse (to Dr. Oser). Grant Number: K01DA021309
- hepatitis C virus;
- injection drug use;
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. J. Med. Virol. 84:1376–1387, 2012. © 2012 Wiley Periodicals, Inc.