Hepatitis C virus (HCV) is a major cause of liver disease worldwide and a potential cause of substantial morbidity and mortality in the future. The complexity and uncertainty related to the geographic distribution of HCV infection and chronic hepatitis C, determination of its associated risk factors, and evaluation of cofactors that accelerate its progression, underscore the difficulties in global prevention and control of HCV. Because there is no vaccine and no post-exposure prophylaxis for HCV, the focus of primary prevention efforts should be safer blood supply in the developing world, safe injection practices in health care and other settings, and decreasing the number of people who initiate injection drug use.

https://courses.washington.edu/conj504/readings/alter_reading3.pdf

Global epidemiology of hepatitis C virus infection

This 1966 paperback edition of a publication which first appeared in 1963 has by now been widely reviewed as a worthy contribution to the sociological study of deviant behavior. Its current appearance as a paperback is a testimonial both to the quality of the work and to the prominence of deviant behavior in this generation. In general the author places deviance in perspective, identifies types of deviant behavior, considers the role of rule makers and enforcers, and some of the problems in studying deviance. In addition, he develops a sequential model of deviance relying on the concept of career, a concept originally developed in studies of occupations. In his study of a particular kind of deviance, the use of marihuana, the author posits and tests systematically an hypothesis about the genesis of marihuana use for pleasure. The hypothesis traces the sequence of changes in individual attitude

Outsiders Studies in the Sociology of Deviance.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.2051-5545.2011.tb00014.x

Physical illness in patients with severe mental disorders.I. Prevalence, impact of medications and disparities in health care

Prevalence of hepatitis C virus infection in the United States.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2002.36806

Natural history of chronic hepatitis C

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.510300504

The impact of diagnosis of hepatitis C virus on quality of life.

Initiation into injecting is a crucial event for continued reproduction of an injecting drug using (IDU) population and for exposure to blood-borne viruses, but little is known about how this happens. Three hundred young injectors were interviewed in Melbourne by peer workers within the first few years of beginning to inject, about the circumstances surrounding their initiation. Most had indications of social disruption, including having left school early, unemployment, family disruption, homelessness and incarceration. First drug injected was most often amphetamines (average age 16 years), most having already used amphetamines by a different route of administration, but with a steady movement thereafter to heroin as the drug of choice. The most common scenario was one in which injecting was unplanned but the person was active in bringing about the initiation. Most identified a significant other who initiated them (few of whom were dealers), and over half had subsequently initiated others into injecting, on average 0.6 per year; after 5 years 237 young injectors had initiated at least 420 others. Those who initiated multiple others were more likely to be unemployed, to inject multiple drugs and to have dealt. Modelling injecting as a communicable phenomenon, where appropriate, may help estimate population dynamics among IDUs. Peer education programmes are likely to be the most effective harm reduction approach among new injectors.

The first hit: circumstances surrounding initiation into injecting

Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings

STUDY OBJECTIVE: To review the epidemiology of hepatitis C virus (HCV) infection among injecting drug users (IDUs) in Australia, and consider needs for further research and prevention policies and programmes. DESIGN: (1) Review of the results of surveillance for HCV; (2) review of published literature on prevalence, incidence, and risk factors for HCV among IDUs; and (3) reconstruction of incidence rates from prevalence studies of HCV in IDUs. SETTING AND PARTICIPANTS: Field and clinic based studies of IDUs in Australia. MAIN RESULTS: HCV has been present at high prevalences (of the order of 60-70%) in populations of Australian IDUs since at least 1971. Duration of injecting and main drug injected were the main predictors of seropositivity, the latter possibly a surrogate for frequency of injecting and both together as surrogate for cumulative numbers of times injected. Risk of infection begins with first injection and continues as long as injecting does. Current incidence is approximately 15 per 100 person years, and up to 40 per 100 person years in some subpopulations. Incidence may have decreased through the 1980s as a result of behaviour change in relation to HIV, as it has for hepatitis B, but not significantly so. CONCLUSIONS: Control of HCV infection in Australia will depend on effectiveness of measures to control HCV spread among IDUs. This will be a greater challenge than the control of HIV in this population has been. Needs identified include improved surveillance, especially for recently acquired infection, better understanding of exact transmission modes, and urgent improvement in prevention strategies.

https://jech.bmj.com/content/jech/51/6/692.full.pdf

Epidemiology of hepatitis C virus infection among injecting drug users in Australia.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2000.9714

Nick Crofts

Papers

The impact of diagnosis of hepatitis C virus on quality of life.

The first hit: circumstances surrounding initiation into injecting

Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings

Epidemiology of hepatitis C virus infection among injecting drug users in Australia.

Assessment of long-term outcomes of community-acquired hepatitis C infection in a cohort with sera stored from 1971 to 1975.