Hepatitis C Virus Infection In Drug Users Research Articles

Seroepidemiology of Hepatitis C Among Drug Users at a Detoxification Center in Southeast China

Background: Hepatitis C virus (HCV) infection is prevalent worldwide, especially among drug users. The epidemiology of HCV is rarely reported among drug users in developing countries, including China. Objectives: We aimed to describe the seroepidemiology of HCV infection in drug users at a Detoxification Center in Southeast China. Methods: With approval from the Shantou Center for Disease Control, the archived data of drug users (n = 5,228) at the largest monitored-detoxification center in Shantou during 2011 - 2017 were analyzed for demographics, risk behaviors, and HCV serology. Results: Among HCV-tested drug users, 36.9% (1930/5228) were people who inject drugs (PWID). The mean annual HCV seroprevalence rate over the seven-year study period was 36.3% for all drug users, including 67.3% and 16.6% for PWID and non-PWID, respectively, with the highest prevalence (78.1%) in 2017 and the lowest prevalence (58.6%) in 2015 for PWID. Independent risk factors of HCV infection identified by multiple logistic regression analysis were engaging in unprotected sex (OR = 1.553, 95% CI = 1.078 - 2.236), injecting drugs (10.28, 8.98 - 11.763), and sharing needles/syringes (2.24, 1.129 - 4.445) for all drug users and sharing needles/syringes (2.062, 1.438 - 2.957) for PWID. Conclusions: This study reports the seroepidemiology of drug users in the monitored Detoxification Center in Southeast China. A relatively high HCV positivity rate, especially among PWID, their high-risk behaviors and low education, and lack of institutional interventions of HCV monitoring and transmission call for government-sponsored educational programs to raise drug users’ awareness of the risk of HCV infection and other co-infections and monitoring of the infectious status and treatment of HCV-infected drug users.

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

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.

A national multidisciplinary healthcare network for treatment of hepatitis C in people who inject drugs in Slovenia.

A national multidisciplinary healthcare network for treatment of hepatitis C in people who inject drugs in Slovenia.

Evolution of HCV incidence in drug users in France

Over the last 40 years, the dynamics of hepatitis C virus (HCV) infection in drug users has been affected by the illicit drug market, the health environment including the devastating impact of the HIV/AIDS epidemic which erupted in the 1980s, and the diffusion of substitution treatment beginning in 1995. The purpose of this literature review is to present the dynamics of HCV infection in drug users in France over the last 40 years. Two prevalence studies of HCV infection in the general population were conducted by the French Institute for Public Health Surveillance in 1994 and 2004 and were the touchstone data sources for this analysis. Hypotheses constructed from the findings of these two studies were examined in light of results reported by multicentre prevalence and incidence studies in drug-user populations. The incidence of HCV infection in drug users in France reached a peak in the late 1980s or early 1990s after a lengthy period of epidemic expansion. Implementation of a risk reduction policy enabled a very significant reduction in the incidence of HCV infection in drug users over the last 20 years, leading to incidence figures which are now 10-15% of the 1990 estimate.

NK cell inhibition receptor genes and HLA –DRB1*1201 in Spontaneous Clearance of Hepatitis Virus Infection. (35.16)

Abstract Host genetic factors play an important role in the evolution of hepatitis C virus (HCV) infection. The aim of this study was to analyze the MHC-KIR combinations associated with the susceptibility and clinical outcome of HCV infection in drug users with Puerto Rican American ethnic background. A total of 160 HCV infected drug users (121 with chronic viremia (CV) and 39 with spontaneous clearance (SC)). Frequencies of KIR inhibitory and activating receptors and MHC class I ligands in HCV infected patients were analyzed using DNA methods. We also used a novel approach to rule out genetic stratification. We report a significant association between HLA-C1/C1 and KIR2DL3/KIR2DL3 with SC was detected confirming previous studies in Caucasian and African Americans. In addition we found MHC class II associations with clinical outcome different to those reported in Caucasians. Our results support the existence of interactions between HLA-C1 and KIR2DL3 genes in HCV viral outcome consistent with loss of inhibition mediated by HLA-C1 and inhibitory functions of KIR2DL3 together with the presence of HLA-DRB1*1201 consistent with negative epistasis.