The Low Prevalence of Hepatitis C Virus and Human Immunodeficiency Virus Coinfection and Hepatitis C Virus Mono-Infection Among Methadone Toxicity Patients

Abstract

the incidence of Hepatitis C Virus (HCV)and Human Immunodeficiency Virus(HIV) coinfection in People Who InjectDrugs (PWIDs) is a public health issue; itpresents various contentions to the healthcareproviders. Although antiretroviral therapy improvedthe life expectancy of HIV-infected people, HCV-relatedmortality turned into a greater concern among these individuals[1]. AccFurthermore, they mentioned, “injectingdrug users in the Taipei methadone maintenancetreatment program had a very high prevalence of HIV/HBV coinfection and HCV mono-infection”[2].Besides, a systematic review and meta-analysis resultssuggested a high frequency of HIV/HBV coinfection(>80%) in Intravenous (IV) drug users [3]. Althoughthe incidence of HIV among IV drug users has beendecreased, HCV is still endemic in this population [4].We aimed to estimate HCV/HIV coinfection frequencyand its related risk factors among methadone poisonedpatients who were admitted to the Loghman Hakim poisoningcenter between March 2012 and March 2017.Loghman-Hakim Hospital is a unique poisoning referralcenter in Tehran, Iran, that admits patients from all citiesin Tehran Province, Iran. Annually, around 20000 hospitalizedpatients are observed and treated in this center,with 80-100 patients daily turn-over.The required data were collected using a questionnaire,clinical examinations, and laboratory findings. The patientswith a history of infectious diseases, like hepatitisB or C, HIV, and IV drug consumption, were excludedfrom the present research. The obtained blood sampleswere screened for antibodies to HCV and HIV using acommercially available Enzyme-Linked ImmunosorbentAssay (ELISA). Furthermore, the relevant urine sampleswere analyzed for the presence of methadone with a rapidtest. Among 200 participants, 134 (67%) were male, and66 (33%) were female with the age range of 1 to 83 years.The methadone serum levels of 129 (64.5%) patients werepositive, 39 (19.5%) were negative, and 32 (16%) patientswere not examined due to the short duration of hospitalization(i.e. <2 days). Underlying diseases, such as noncommunicablediseases (11%), psychotic disorders (1.5%), andrespiratory disease (3.5%) were detected in 30 cases. ReactiveHCV-antibodies, active HIV-antibodies, and HIV/HCV coinfection were observed in 10 (5%), 2 (1%), and 2(1%) of the study subjects, respectively. Figure 1 shows theprevalence of HCV and HIV infection by gender and age.