Abstract
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.
Highlights
Hepatitis C virus (HCV) is a leading cause of chronic liver disease, including hepatitis, cirrhosis, and hepatocellular carcinoma [1,2,3,4]
The most significant predictors of HCV seropositivity were injecting drug use and a history of drug use 9 years (AOR: 2.01, 95% confidence intervals (CI): 1.96–2.06, p
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%
Summary
Hepatitis C virus (HCV) is a leading cause of chronic liver disease, including hepatitis, cirrhosis, and hepatocellular carcinoma [1,2,3,4]. While HCV transmission can occur via a variety of modes, the most common route is injecting drug use [3], and HCV is the most common viral infection among injecting drug users (IDU) worldwide[8, 9]. China’s drug user (DU) population has been estimated to be as high as 3.5 million, most of whom are opioid users and use drugs by injecting [10]. Meta-analyses have estimated a national HCV antibody prevalence of 67.0% among IDU and 60.1% among DU in methadone maintenance treatment (MMT) [12, 13]. Hepatitis 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
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