Abstract
BackgroundHCV (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users. However, there are no special HCV or HIV (human immunodeficiency virus)-related intervention programs that are tailored for drug users in China; to fill this gap, the purpose of this study was to explore HCV and HIV-related knowledge among drug users in MMT (methadone maintenance treatment) sites of China and to investigate the effectiveness of HCV and HIV-related education for improving the knowledge of IDUs (injection drug users) and their awareness of infection.MethodsThe study was a randomized cluster controlled trial that compared a usual care group to a usual care plus HCV/HIV-REP (HCV/HIV-Reduction Education Program) group with a 24-week follow-up. The self-designed questionnaires, the HCV- and HIV-related knowledge questionnaire and the HIV/HCV infection awareness questionnaire, were used to collect the data. Four MMT clinics were selected for this project; two MMT clinics were randomly assigned to the research group, with subjects receiving their usual care plus HCV/HIV-REP, and the remaining two MMT clinics were the control group, with subjects receiving their usual care over 12 weeks. Sixty patients were recruited from each MMT clinic. A total of 240 patients were recruited. Follow-up studies were conducted at the end of the 12th week and the 24th week after the intervention.ResultsAt baseline, the mean score (out of 20 possible correct answers) for HCV knowledge among the patients in the group receiving the intervention was 6.51 (SD = 3.5), and it was 20.57 (SD = 6.54) for HIV knowledge (out of 45 correct answers) and 8.35 (SD = 2.8) for HIV/HCV infection awareness (out of 20 correct answers). At the 12-week and 24-week follow-up assessments, the research group showed a greater increase in HCV−/HIV-related knowledge (group × time effect, F = 37.444/11.281, P < 0.05) but no difference in their HIV/HCV infection awareness (group × time effect, F = 2.056, P > 0.05).ConclusionAn MMT-based HCV/HIV intervention program could be used to improve patient knowledge of HCV and HIV prevention, but more effort should be devoted to HIV/HCV infection awareness.Trial registrationProtocols for this study were approved by institution review board (IRB) of Shanghai Mental Health Center (IRB:2009036), and registered in U.S national institutes of health (http://www.clinicaltrials.gov, NCT01647191). Registered 23 July 2012.
Highlights
hepatitis C virus (HCV) (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users
Baseline assessments and drug use history A total of 267 methadone maintenance treatment (MMT) patients were recruited from the four selected MMT clinics, with 27 (10.1%) excluded due to different reasons (Fig. 1)
As the first randomized study among drug users in China, the study indicated that the high prevalence of HCV (70%) among drug users in MMTs in Shanghai was higher than the prevalence estimates of 67.0% from the meta-analyses among injection drug user (IDU) and 60.1% among IDUs in MMTs in China [25]; it was higher than the global HCV prevalence among drugs users (67%) [26]
Summary
HCV (Hepatitis C virus) is a prevalent chronic disease with potentially deadly consequences, especially for drug users. HCV is a prevalent chronic disease with potentially deadly consequences. The global HCV positive prevalence is forecasted at 1.1% (0.9–1.4%), with an estimated population of 80 (64–103) million patients [1]. China faces a similar situation, with an HCV prevalence among the general Chinese population varying from 0.43 to 2.2%, corresponding to a range of 6 million to 30 million people [2, 3]. High risk factors for HCV infection include injection drug use and transfusion of blood products [4]. It is not surprising that HCV infection prevalence among IDU in China is thought to be very high, ranging from 15.6 to 98.7% in different provinces [6]
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