Hepatitis C among methadone maintenance treatment patients in Shanghai and Kunming, China

Hser, Yih‐Ing; Du, Jiang; Li, J.; Zhao, Min; Chang, Yen Jung; Peng, Ching Yi; Evans, Elizabeth

doi:10.1093/pubmed/fdr098

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…The average daily dosage of methadone among HCV-seropositive patients was significantly higher than that of HCV-seronegative patients, suggesting that HCV-positive patients had a heavier addiction to drugs. HCV seropositivity rate in our survey (58.0%) was similar to previously reported HCV infection rate in patients undergoing MMT in Beijing (58.5%), (51.3%) Shanghai (51.3%) and Kunming (55.5%) ( 24 , 25 ), but higher than patients from drop-in centers in Iran (43.4%) ( 18 ) and lower than patients undergoing MMT in Wuhan (82.3%) ( 26 ) and Hong Kong (85.0%) ( 27 ). Another study showed that fewer than a half of heroin users were still HCV-seronegative by the time they presented to MMT clinics in Xi’an, whereas drug users were likely to be infected with HCV when starting heroin within the first year and HCV positivity rate increased with the duration of drug use ( 28 ).…”

Section: Discussionsupporting

confidence: 90%

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi’an, China

Wei

Wang

et al. 2014

Hepat Mon

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Background:Hepatitis C virus (HCV) infection rates in drug users vary among different regions of China. Drug users who are unaware of their HCV serostatus tend to engage in more risky behaviors.Objectives:This prospective study aimed to assess risk factors of HCV infection in drug users among 11 methadone maintenance treatment (MMT) clinics in Xi’an, China.Patients and Methods:Baseline characteristics and drug use information of patients were collected upon enrollment in the study and anti-HCV tests were performed within one month after the enrollment. Data on daily medication, monthly random urine morphine test results, illicit drug use and MMT retention time were recorded during a 5-year follow-up.Results:Of 10243 patients, 58.0% had positive results for anti-HCV. Injection drug use, longer duration of drug abuse, older age, female gender, unmarried status and unemployment were independent risk factors of HCV infection. Urine test positivity rate was lower (14.8% vs. 16.7%, χ2 = 100.235, P < 0.05), but MMT retention rate was higher (log-rank χ2 = 4.397, P < 0.05) in the anti-HCV positive group than anti-HCV negative one. However, multivariate regression revealed no significant association between anti-HCV serostatus and either MMT retention time or illicit drug use.Conclusions:The major risk factor of HCV infection was injection drug use. The patient’s awareness of his or her HCV status had a minor effect in reduction of illicit drug use and improvement in MMT retention. Therefore, adequate counseling is necessary for drug users in MMT clinics in Xi’an.

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Section: Discussionsupporting

confidence: 90%

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi’an, China

Wei

Wang

et al. 2014

Hepat Mon

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“…We were unable to determine the rate of testing uptake, although other studies have noted high (>75%) uptake of HCV testing in OST settings (Harris et al, 2010;Hser et al, 2012). Given the potential for undiagnosed HCV infection in the cohort, our findings are likely to underestimate true HCV incidence in this population.…”

Section: Limitationsmentioning

confidence: 78%

Opioid substitution therapy is associated with increased detection of hepatitis C virus infection: A 15-year observational cohort study

Larney

Grebely²,

Falster

et al. 2015

Drug and Alcohol Dependence

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“…The factors most strongly associated with HCV infection were related to drug use history, which has been addressed in depth in the literature. The prevalence of HCV increased with longer histories of drug use [ 3 , 25 – 27 ]. HCV infection was also much more likely to be present among IDUs and HIV-positive clients [ 3 , 8 , 19 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China’s National Methadone Maintenance Treatment Program

Wang¹,

Shi²,

Rou³

et al. 2016

PLoS ONE

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BackgroundHepatitis C virus (HCV) is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT) program.MethodsData from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution.ResultsAnti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17–8.52, p<0.0001) and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96–2.06, p<0.0001). Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001). Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012.ConclusionsThe current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China.

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Hepatitis C among methadone maintenance treatment patients in Shanghai and Kunming, China

Abstract: The high HCV prevalence and the general lack of knowledge about HCV infection, transmission and treatment suggest the need to provide HCV education and health promotion programs among patients in MMT.

Cited by 12 publications

References 21 publications

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi’an, China

Risk Factors of Hepatitis C Virus Infection in Drug Users From Eleven Methadone Maintenance Treatment Clinics in Xi’an, China

Opioid substitution therapy is associated with increased detection of hepatitis C virus infection: A 15-year observational cohort study

Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China’s National Methadone Maintenance Treatment Program

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