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Per-event probability of hepatitis C infection during sharing of injecting equipment.

Boelen L, Teutsch S, Wilson DP, Dolan K, Dore GJ, Lloyd AR, Luciani F, HITS investigators

  • Journal PloS one

  • Published 07 Jul 2014

  • Volume 9

  • ISSUE 7

  • Pagination e100749

  • DOI 10.1371/journal.pone.0100749


Shared injecting apparatus during drug use is the premier risk factor for hepatitis C virus (HCV) transmission.

To estimate the per-event probability of HCV infection during a sharing event, and the transmission probability of HCV from contaminated injecting apparatus.

Estimates were obtained using a maximum likelihood method with estimated IDU and sharing events obtained from behavioural data.

Cohort study in multiple correction centres in New South Wales, Australia.

Subjects (Nā€Š=ā€Š500) with a lifetime history of injecting drug use (IDU) who were followed up between 2005 and 2012. During follow-up, interviews for risk behaviours were taken and blood sampling (HCV-antibody and RNA testing) was performed.

Self-reported frequencies of injecting drugs and sharing events, as well as other risk behaviours and details on the nature of injecting events.

The best estimate of the per-event probability of infection was 0.57% (CI: 0.32-1.05%). A sensitivity analysis on the likely effect of under-reporting of sharing of the injecting apparatus indicated that the per event infection probability may be as low as 0.17% (95% CI: 0.11%-0.25%). The transmission probability was similarly shown to range up to 6%, dependent on the presumed prevalence of the virus in injecting equipment.

The transmission probability of HCV during a sharing event is small. Hence, strategies to reduce the frequency and sharing of injecting equipment are required, as well as interventions focused on decreasing the per event risk.