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Trends in HCV Prevalence and Risk Factors Among People who Inject Drugs in Los Angeles County, 2012–2024

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Abstract

Evaluating trends in Hepatitis C virus (HCV) prevalence is critical for tracking the progress in HCV elimination efforts. We evaluated the changes in the prevalence of HCV infection (HCV antibody) among people who inject drugs (PWID) participating in the National HIV Behavioral Surveillance in Los Angeles County (LAC). Steady decreases in HCV antibody seroprevalence over time was observed among PWID from 81.2% in 2012 to 64.9% in 2015, 59.1% in 2018, 50.1% in 2022, and 34.2% in 2024. Chronic HCV infection (positive on both antibody and RNA tests) also declined from 37.1% in 2018 to 30.6% in 2022 and 18.2% in 2024. This downward pattern is further supported by multivariable analyses which showed a consistent reduction in HCV prevalence over time (aPR = 0.91, 95% CI 0.89–0.92). The largest decreases occurred among participants aged ≥ 30 years and among female PWID, with both decreasing 9.1% annually. HCV antibody positivity remained significantly higher among males, those with lower education, daily injectors, participants with incarceration history, and those engaging in receptive syringe sharing. Decreases in HCV antibody and RNA prevalence, alongside improved sterile injection practices, greater awareness of HCV status, and increases in treatment uptake, may reflect the impact of harm reduction efforts at reducing transmission among PWID in LAC. To achieve and sustain equitable progress, it remains essential to continue expanding HCV testing and treatment, particularly for communities that have not yet fully benefited from these interventions.

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Funding

Funding was provided by the Centers for Disease Control and Prevention (FOA: PS0003256, PS 16-1601, PS22-2201). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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  1. Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA, USA

    Yingbo Ma, Ekow Kwa Sey, Hugo Santacruz, Jennifer Kwon, Pierre Chambers & Siri Chirumamilla

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Ma, Y., Sey, E.K., Santacruz, H. et al. Trends in HCV Prevalence and Risk Factors Among People who Inject Drugs in Los Angeles County, 2012–2024. AIDS Behav (2026). https://doi.org/10.1007/s10461-026-05072-y

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