Living as a Couple Is Associated with Hepatitis C Risk Practices

People with illicit opioid use are at risk for acquiring hepatitis C (HCV) through shared injection paraphernalia. Researchers investigated HCV risk practices among 176 patients initiating methadone maintenance treatment, including: sharing injection paraphernalia, sharing toiletry items (e.g., razors, toothbrushes, nail scissors), having non-professional tattoos/piercings, or blood contact. Participants were asked whether they were living as a couple with someone with injection drug use.

• At baseline, 34 participants (19%) reported at least one HCV risk practice, 6% reported a drug-related risk practice, and 16% reported other practices.
• On unadjusted analysis, HCV risk practices were associated with female gender, younger age, DSM-IV alcohol dependence, cocaine use, and injection drug use, as well as longer history of drug use, depressive symptoms, and suicide risk. Living with others (as a couple or not) was also associated with HCV risk factors.
• On multivariable analysis, five variables were associated with an HCV risk practice: younger age, alcohol dependence, cocaine use, suicide risk, and living as a couple (regardless of whether partner had injection drug use). When excluding sharing of toiletry items as a risk factor, only suicide risk and living as a couple with a person with injection drug use were significantly associated with HCV risk practices.

Comments:

This study points out that when assessing HCV risk and counseling on transmission, we should be considering patients’ partners and remember that HCV can be transmitted by means other than sharing injection paraphernalia, such as sharing razors.

Darius A. Rastegar, MD

Reference:

Roux P, Lions C, Michel L, et al. Factors associated with HCV risk practices in methadone-maintained patients: the importance of considering the couple in prevention interventions. Subst Abuse Treat Prev Policy. 2014;9:37.