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High Prevalence of Hepatitis C Virus Infection Among Russian Immigrants in the New York City Metropolitan Area: Results of A Community-Based Screening Program
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DDW, May 21-24, 2006, Los Angeles, (Digestive Disease Week)
I. Khaykis1; S. Batash1; R. F. Raicht1, 2; E. J. Bini1, 2
1. Division of Gastroenterology, NYU School of Medicine, New York, NY, USA.
2. Division of Gastroenterology, VA New York Harbor Healthcare System, New York, NY, USA.
Background: Inadequate sterilization and re-use of medical equipment may have contributed to hepatitis C virus (HCV) transmission in the former Soviet Union. Although New York (NY) leads the nation in the number of Russian Americans (1.6 million in the NY Tri-State area), the epidemiology of HCV infection has not been evaluated in this population. The aims of this study were to determine the prevalence of and risk factors for HCV infection among Russian immigrants in the NY metropolitan area.
Methods: We conducted a 3-day community-based HCV screening program in the 2 boroughs of the NY Tri-State area with the highest density of Russian immigrants (Brooklyn and Queens). Russian radio and cable television were used to invite patients to come in for free HCV counseling and testing. In the last 2 days of screening, each person also completed a HCV risk factor questionnaire.
Results: The overall prevalence of HCV positivity among the 283 subjects (age 51.9 ± 15.7 years; 53.4% female) was 28.3% (95% CI 23.0% - 33.5%). Although there was no difference in the prevalence of HCV infection between men and women (30.3% vs 26.5%, P = 0.48), there was a linear trend towards an increasing prevalence with age (21.4% in subjects <30 years old and 35.0% in those ≥70 years old). Among those who completed the questionnaire, the mean number of years in the U.S. was 10.7 ± 6.1, with the majority either from Uzbekistan (32.0%), Ukraine (29.9%), or Russia (18.6%). Prior injection drug use was uncommon (2.1%), and only 22.7% reported ≥10 lifetime sexual partners. The prevalence of HCV infection was 11.1% in immigrants from Russia, 29.0% from Uzbekistan, 31.0% from the Ukraine, and 36.8% from other regions. Although IM injections (OR=11.1; 95% CI 2.4 - 50.7), blood transfusion (OR=4.3; 95% CI 1.7 - 11.2), hospitalization (OR=4.2; 95% CI 1.4 - 12.2), and surgery (OR=3.3; 95% CI 1.1 - 9.7) were significantly associated with HCV positivity in univariate analysis, only IM injections (OR=9.1; 95% CI 2.0 - 42.4) and blood transfusion (OR=3.2; 95% CI 1.2 - 9.0) remained independently associated with HCV infection in multivariable analysis.
Conclusions: In this community-based HCV screening program, we found a high prevalence of HCV infection among Russian immigrants in the NY metropolitan area. It is likely that the use of inadequately sterilized medical equipment and blood transfusions were the primary modes of HCV transmission in this population. Given the high prevalence of HCV infection in Russian immigrants, universal HCV testing should be strongly considered in this population.
This study was funded by a grant from Roche Pharmaceuticals and the American Liver Foundation.
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