HCV and HIV Infection among Heroin Addicts in Methadone Maintenance Treatment (MMT) and Not in MMT in Changsha and Wuhan, China

Wang, Xuyi; Tan, Linxiang; Li, Yang; Zhang, Yao; Zhou, Demin; Liu, Tieqiao; Hao, Wei

doi:10.1371/journal.pone.0045632

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…All results are shown in Table 1. The high HCV prevalence found in the IDU is in agreement with several reports from other countries regarding the risk of injection behavior for HCV infection [1,[11][12][13]. This result is not in agreement with a previous report showing the absence of HCV infection among illegal drug users in Bucaramanga, Colombia [4] and it may be associated with the low prevalence of heroin use in the studied population (3.9%).…”

supporting

confidence: 72%

Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

Sepúlveda-Arias

Isaza

Vélez³

2014

J Infect Dev Ctries

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supporting

confidence: 72%

Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

Sepúlveda-Arias

Isaza

Vélez³

2014

J Infect Dev Ctries

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“…The HCV antibody-positive patients in our current study cohort had a lower S -EDDP/methadone ratio, but higher plasma R -methadone concentration and might therefore benefit from R -methadone induced withdrawal prevention. This partly explains the high percentage of HCV antibody-positive patients in the MMT programs in Taiwan and in Asia [30], [31] in which HCV causes an increase in S -methadone elimination and a reduction in adverse reactions. Our current study is the first to identify that HCV infection may influence methadone metabolism, particularly S -methadone metabolism.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Infection Influences the S-Methadone Metabolite Plasma Concentration

Wang

Tsou

et al. 2013

PLoS ONE

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Background and ObjectivesHeroin-dependent patients typically contract hepatitis C virus (HCV) at a disproportionately high level due to needle exchange. The liver is the primary target organ of HCV infection and also the main organ responsible for drug metabolism. Methadone maintenance treatment (MMT) is a major treatment regimen for opioid dependence. HCV infection may affect methadone metabolism but this has rarely been studied. In our current study, we aimed to test the hypothesis that HCV may influence the methadone dosage and its plasma metabolite concentrations in a MMT cohort from Taiwan.MethodsA total of 366 MMT patients were recruited. The levels of plasma hepatitis B virus (HBV), HCV, human immunodeficiency virus (HIV) antibodies (Ab), liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) were measured along with the urine morphine concentration and amphetamine screening.ResultsOf the 352 subjects in our cohort with HCV test records, 95% were found to be positive for plasma anti-HCV antibody. The liver functional parameters of AST (Wilcoxon Rank-Sum test, P = 0.02) and ALT (Wilcoxon Rank-Sum test, P = 0.04), the plasma methadone concentrations (Wilcoxon Rank-Sum test, P = 0.043) and the R-enantiomer of methadone concentrations (Wilcoxon Rank-Sum test, P = 0.032) were significantly higher in the HCV antibody-positive subjects than in the HCV antibody-negative patients, but not the S-EDDP/methadone dose ratio. The HCV levels correlated with the methadone dose ( = 14.65 and 14.13; P = 0.029 and 0.03) and the S-EDDP/methadone dose ratio ( = −0.41 and −0.40; P = 0.00084 and 0.002) in both univariate and multivariate regression analyses.ConclusionsWe conclude that HCV may influence the methadone dose and plasma S-EDDP/methadone dose ratio in MMT patients in this preliminary study.

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“…Nineteen studies reported the prevalence of HCV infection in high-risk populations: ten were from China [17][18][19][20][21][22][23][24][25][26], two from Japan [27,28], two from Korea [29,30] and five from Taiwan [12,[31][32][33][34]. Among high-risk populations, the prevalence of HCV infection was higher among IDUs (48-95 % in China, Table 4).…”

Section: Prevalence Of Hcv Infection In High-risk Populationsmentioning

confidence: 99%

A review of the burden of hepatitis C virus infection in China, Japan, South Korea and Taiwan

Bennett¹,

Waser²,

Johnston³

et al. 2015

Hepatol Int

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Hepatitis C virus (HCV) infection is associated with substantial clinical and economic burden and is an important public health issue in Asia. The objective of this review was to characterize HCV epidemiology and related complications in China, Japan, South Korea and Taiwan. A search of electronic databases and conference abstracts identified 71 potentially relevant articles. Of those, 55 were included in the epidemiology review and 9 in the review of HCV-related complications. HCV prevalence in the general population was 1.6% in China, 0.6-0.9% in Japan, 0.6-1.1% in South Korea and 1.8-5.5% in Taiwan. Prevalence was higher for injecting drug users (48-90%) and those with human immunodeficiency virus coinfection (32-85%) and was lower for blood donors (<1%). Annual incidence of HCV in China was 6.01 per 100,000. HCV genotype 1b was associated with the highest incidence of hepatocellular carcinoma (HCC). Five-year survival for patients with liver cirrhosis was 73.8%, decreasing to 39.2% following liver transplantation; the majority of deaths were attributable to HCC. Limitations were that the majority of studies included in the epidemiology review were small, regional studies conducted in specific populations, and there was an absence of large population-based studies. Thus, estimates may not be representative of the epidemiology of HCV for each country. The prevalence HCV in China and HCV incidence in the Asian region remain largely unknown, and they are likely underestimated. Further epidemiologic and clinical data are needed to provide more precise estimates for use by public health agencies.

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HCV and HIV Infection among Heroin Addicts in Methadone Maintenance Treatment (MMT) and Not in MMT in Changsha and Wuhan, China

Cited by 10 publications

References 24 publications

Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

Hepatitis B and C prevalence among heroin addicts in methadone maintenance treatment (MMT) and not in MMT in Pereira, Colombia

Hepatitis C Virus Infection Influences the S-Methadone Metabolite Plasma Concentration

A review of the burden of hepatitis C virus infection in China, Japan, South Korea and Taiwan

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