“We studied four Northern California counties, and San Francisco had the highest HCV infection level, 4.3%--nationally the level is 1.8%. Injection drug use is the strongest risk factor, but we were surprised to find that co-infection with herpes simplex virus type-2 (HSV-2) was also significantly associated with hepatitis C infection. This suggests that infection with HSV-2 may be a co-factor for sexual transmission of hepatitis C,” said Kimberly A. Page-Shafer, PhD, MPH, assistant professor of medicine at UCSF’s Center for AIDS Prevention Studies, lead author of the study published in the April issue of the American Journal of Public Health.
“We also found that non-injection drug use, specifically cocaine, contributed appreciably to increased risk. Public health efforts to prevent transmission of hepatitis C virus in low-income areas need to go beyond needles and include interventions to reduce sexually transmitted diseases and non-needle drug use,” said Page-Shafer.
The study analyzed data collected from the Young Women’s Survey, a population-based door to door survey that measured the prevalence of HIV, sexually transmitted diseases, and related risk behavior in young women in Northern California residing in low-income neighborhoods (US census block groups below the tenth percentile for median household income). After San Francisco, Alameda County had the next highest HCV prevalence, 3.8%. In San Joaquin County 1.4% of women were infected. No HCV infections were identified in San Mateo County.
Very low income was the strongest socioeconomic correlation. Of the women in the study whose income was below five hundred dollars a month, 5.1% were infected with HCV.
Co-authors include Barbara Cahoon-Smith, PhD, from the East Bay Liver Clinic in Oakland; Jeffrey D. Klausner, MD, MPH, director of sexually transmitted disease prevention and control services and Willi McFarland, MD, PhD, director of the HIV seroepidemiology unit, San Francisco Department of Public Health; Scott Morrow, health officer, San Mateo County Health Department; Fred Molitor, PhD, epidemiologist and Juan Ruiz, MD, DrPH, acting chief of the HIV/AIDS epidemiology branch, Office of AIDS, California Department of Public Health.
Funding from the Centers for Disease Control and from the San Francisco Department of Public Health’s AIDS Office and STD Prevention and Control Branch supported this study.
Journal
American Journal of Public Health