High prevalence but low awareness of hepatitis C virus infection among heroin users who received methadone maintenance therapy in Taiwan (original) (raw)
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HCV and HIV Infection among Heroin Abusers in a Methadone Maintenance Treatment Program
Health, 2016
Over the years, it was getting attention to hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection among injected drug users (IDUs) in Taiwan. This study investigated the frequency of risky behaviors for HCV carriers and IDUs who were HIV carriers in methadone maintenance treatment program. The subjects, intravenously injected heroin abusers, were collected from a special methadone maintenance treatment clinic. The survey included characteristics of participants, sexual activity and attitude towards condom usage. The total number of subjects was 151. Data were analyzed using the statistical package SPSS 15.0. The analytical methods included descriptive analysis, Fisher's exact test, and the logistic regression model. The study showed that 82% of intravenously injected heroin abusers were hepatitis C virus (HCV)-positive, and 44.4% were hepatitis B virus (HBV)-positive; 89.5% of HIV-positive heroin abusers were type C hepatitis positive. Only 21.2% of these intravenously injected heroin abusers always used a condom, and 39.7% never used a condom during sexual activity. Logistic regression analysis showed smoking, sharing syringes needles, HBV status and condom use status were four main risk factors on HIV infection. Sharing or using contaminated syringes needles was the main cause of HIV, HBV, and HCV infection in the drug addiction group. Since our government has the policy of providing a methadone maintenance treatment program, the spread of HIV is under control, but knowledge about HIV and safe sex education still needs improvement.
Hepatitis C among methadone maintenance treatment patients in Shanghai and Kunming, China
Journal of public health (Oxford, England), 2012
Background This study aims to: (1) document the prevalence of hepatitis C virus (HCV) among methadone maintenance treatment (MMT) patients in Kunming and Shanghai; (2) examine risk factors for HCV by comparing those who tested positive with those who were negative and (3) examine if HCV serostatus is related to attitudes toward MMT.
High prevalence of HCV in a cohort of injectors on methadone substitution treatment
Journal of Clinical Virology, 2008
Background: In Hong Kong, methadone treatment is widely accessible. Injecting drug users (IDU) have a relatively low risk behavioural profile and low HIV prevalence (0.3%). The corresponding Hepatitis C (HCV) level, however, is unclear. Objectives: To determine the HCV prevalence in IDU in Hong Kong and to identify any associated factors. Study Design: A community-based HCV prevalence study of IDU was conducted in methadone clinics. Demographics and drug use pattern were collected through a questionnaire survey and blood samples were obtained for HCV serological tests. Results: Data of 567 IDU were analyzed. Most were male (84%) and ethnic Chinese (98%). The median age was 49 years and median injection duration 17 years. Two-thirds (62%) admitted ever sharing injecting equipments. Most (76%) reported having injection drug use in the preceding 3 months, and 44% abused midazolam/triazolam in addition to heroin. Prevalence of HCV antibodies was 85% (95% confidence interval 82.5-88.3%). Injection duration, recent injection, ever sharing injecting equipments and concomitant use of other drugs were independent factors associated with HCV infection. Conclusions: HCV prevalence is high in IDU despite a low HIV prevalence and widely available substitution treatment, which has probably slowed but not prevented the HCV epidemic in IDU in Hong Kong.
Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China
International Journal of Epidemiology, 2004
Background Hepatitis C virus (HCV) is quickly spread through injection drug use. The prevalence and incidence of HCV in Chinese heroin users has been rarely reported. Methods A longitudinal cohort of young injection drug users (IDU) from southern China was established to study the risk factors for blood-borne infections (597 subjects). Individuals underwent analysis for the presence of hepatitis B surface antigen and antibodies to human immunodeficiency virus type 1 (HIV-1), HCV and hepatitis B surface antigen. Using self-reported risk behaviours, multivariate regression analysis was performed for factors associated with HCV prevalence and seroconversion. Results At baseline, HIV-1 and HCV prevalence was 17% and 72%, respectively. Significant factors associated with HCV seroprevalence included age Ͼ25 years (odds ratio [OR] = 1.71) and injection drug use for Ͼ2 years (OR = 2.60). HCV prevalence within one year of starting heroin use was 57% for any route of administration, and 80% if restricted to injectors. After two 6-month follow-up visits, 56 out of 159 baseline HCV seronegative individuals (148.9 total person years [py]), underwent seroconversion at an incidence rate of 37.6 per 100 py. Individuals who reported injection drug use were more likely to undergo HCV seroconversion (rate ratio [RR] = 6.59). Conclusions HCV infection is rapidly acquired in heroin users who adopt injection in southern China. This study emphasizes the urgent need to implement and expand injection prevention and primary substance abuse prevention programmes in China.
Hepatitis C virus infection among short-term intravenous drug users in southern Taiwan
European Journal of Epidemiology, 1999
The purpose of this study was to determine the correlation between the prevalence of hepatitis C virus (HCV) infection with duration of drug use and other risk factors among drug users. This survey covered 899 male drug users from Kaohsiung Narcotic Abstention Institute and Kaohsiung prison. The prevalence of positive anti-HCV was 67.2% among intravenous drug users (IVDU) and 14.7%
BMC Infectious Diseases, 2012
Background: Methadone maintenance treatment (MMT) was implemented in China since 2004. It was initiated in 8 pilot clinics and subsequently expanded to 738 clinics by the end of 2011. Numerous individual research studies have been conducted to estimate HIV and HCV prevalence among MMT clients but an overview of the epidemics in relations to MMT remains unclear. The aim of this study is to estimate the magnitude and changing trends of HIV, HCV and HIV-HCV co-infections among entry clients to MMT clinics in China during 2004-2010. Methods: Chinese and English databases of literature were searched for studies reporting HIV, HCV and co-infection prevalence among MMT clients in China from 2004 to 2010. The prevalence estimates were summarized through a systematic review and meta-analysis of published literatures.
Prevalence rates and risk factors for hepatitis C among drug users not in treatment in Malaysia
Drug and Alcohol Review, 2009
Introduction and Aims. The prevalence of hepatitis C virus (HCV) among heroin dependants in treatment was estimated at 89.9%; however, virtually no information exists on the prevalence or risk behaviour among the larger population of drug users not in treatment. This study assessed the prevalence of HCV and associated risk factors among this group with a view to designing more effective intervention programs. Design and Methods. A cross-sectional survey of 552 not-in-treatment drug users recruited from five key urban centres across peninsular Malaysia with on-site serological testing for HCV and HIV seropositivity was conducted. Results. HCV prevalence was 65.4% for the overall sample, but higher among injecting drug users (67.1%) relative to non-injecting drug users (30.8%). Bivariate analysis suggested seven risk factors though only sharing injecting paraphernalia and lifetime homosexual/bisexual behaviour remained significant in multivariate analysis. Discussion and Conclusions. With the majority (65.9%) sharing injecting equipment and about the same proportion (65.4%) being HCV positive, the risk of further transmission to new drug users is high. It is imperative that the nascent needle and syringe exchange and condom distribution program and its ancillary services-launched in 2005 to fight HIV-be fine tuned, as a first step, to control HCV. With its greater infectivity and non-symptomatic character, HCV is more insidious. Given the shared risk factors of HCV and HIV, routine screening of drug users for HCV-currently non-existent-should be instituted. This, with other intervention measures, will help detect and control HCV at an earlier stage while also checking the spread of HIV.
Drug and Alcohol Dependence, 2012
Background: Methadone maintenance treatment (MMT) has rapidly expanded in China, from 8 pilot sites to 696 clinics covering 27 provinces, during 2004-2010. This study evaluates the demographic characteristics and drug use behaviors associated with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) infections among MMT entrants through a systematic review and meta-analysis of published literature. Methods: Thirty-nine eligible articles (1 in English and 38 in Chinese) were selected for this review. We extracted the relevant indicator information from all eligible studies and performed meta-analyses, by stratifying according to sex of the participants, age groups and drug use behaviors. Five provinces (i.e., Yunnan, Guizhou, Sichuan, Guangxi and Xinjiang) with the population size of HIVinfected drug users greater than 10,000 were defined as high transmission areas (HTAs) for HIV infection; whereas the remaining twenty-six Chinese provinces were considered as low transmission areas (LTAs). Results: The odds of being infected by HIV among male drug users were significantly higher than for females in high transmission areas (OR = 1.49, 95% CI: 1.11-1.99, k = 9), while the opposite results were observed in low transmission areas (OR = 0.46, 0.27-0.79, k = 11). In comparison, no significant differences in risk behaviors were found between sexes in HTAs and LTAs. Younger age was not associated with risk of HIV infection, but was associated with higher risk of HCV infection (<30 years OR = 1.88; 30-40 years OR = 2.21, compared with >40 years, k = 17). Risk of HIV infection was higher among injectors than non-injectors (OR = 4.29, 2.70-6.79, k = 14) and for those who inject, there was greater risk among sharers than non-sharers (OR = 2.47, k = 4). Similar patterns were also observed in HCV infection (injectors: OR = 10.82, sharers: OR = 3.41,, k = 7). Conclusions: Characteristics of MMT entrants positive for HIV or HCV in China vary by disease types, geographical region, sex, age, and injecting behavior. These factors need to be considered in targeted interventions for MMT participants, such as age-specific health education and psychological treatment, antiretroviral therapy and needle-syringe exchange programs.
Drug and Alcohol Dependence, 2008
This study aimed to determine the characteristics of heroin users in the first methadone maintenance treatment (MMT) clinic in China.In a retrospective chart review, the notes of 3127 heroin users who received both detoxification and MMT at the clinic were analyzed. Their socio-demographic and clinical data were collected, and the frequency of human immunodeficiency virus (HIV), Hepatitis C virus (HCV), and syphilis infections was investigated.The main findings are as follows: (1) 66.5% of the patients were younger than 35 years; (2) 55.1% were married at admission; (3) 32% were non-local residents; (4) the majority had high school level education, a history of smoking and alcohol consumption prior to the initial heroin use, and did not have stable jobs; (5) 28.4% were self-employed; (6) 5.4% of the sample had total hearing loss coupled with loss of speech; (7) 83.4% sniffed heroin or injected it intravenously at the time of admission, but 87.2% had smoked the drug when they first began abusing it; (8) a significant proportion of the patients were infected with HIV, HCV, and syphilis.Some of the above findings are not consistent with the results of previous studies conducted in Western countries and China. The unique socio-cultural and clinical characteristics of heroin abusers in different regions of China should be considered when MMT services are planned.
Methadone maintenance and hepatitis C virus infection among injecting drug users
Addiction, 1997
Of 1741 individuals tested for HCV antibodies at least once 66.7% were positive. Of 73 IDUs who were initially seronegative and were retested at least once, 19 were subsequently seropositive. Seroconverters to HCV were younger than non-seroconverters, and were more likely to have evidence of previous hepatitis B infection. The overall HCV incidence rate was 22 cases per 100 person-years, and this did not differ between those on MMT programs (continuous or interrupted) between HCV tests and those not on MMT. These findings suggest that the role of AiMT in the control of the spread of HCV infection among IDUs needs further assessment, and that control of the current epidemic of HCV infection among IDUs in Australia will be very difficult.