Recognition of Hepatitis C Virus Coinfection in HIV-Positive Injecting Drug Users in Asia

Abstract

HIV and hepatitis C (HCV) are readily transmitted by the sharing of injecting equipment. It has been estimated that there are 2 to 9 million injecting drug users (IDUs) in the Asia Pacific region of whom approximately 750000 are living with HIV. Injecting drug use is a major mode of HIV transmission in many Asian countries accounting for more than 30% of infections in Myanmar; 40% in China; and most infections in Vietnam Indonesia and Malaysia. This is superimposed on a geographically varied high population prevalence of HCV. Prevalence across Asia can be explained by unsterile medical injections contaminated transfusions traditional cultural practices6 and more recently injecting drug use. There are few studies on the prevalence of HCV and HIV coinfection in Asia although all demonstrate almost universal HCV infection in HIV-infected IDUs. Increasing coinfection as a proportion of HIV infections in some countries indicates that although sexual transmission of HIV may be reducing transmission through sharing injecting equipment continues. A Thai study found that although the prevalence of HIV in military recruits (a marker of population HIV prevalence) decreased from 2.4% to 1.1% between 1995 and 2000 the proportion coinfected increased from 20.8% to 49.5% during the same period. (excerpt)