Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China. (22nd January 2015)

• Record Type: Journal Article
• Authors: Zhou, Wang; Wang, Xia; Zhou, Sheng; Xie, Nianhua; Liu, Pulin; Luo, Li; Peng, Jinsong; Liu, Manqing; Desrosiers, Alethea; Schottenfeld, Richard; Chawarski, Marek C.
• Is Part Of: Addiction. Volume 110:Number 5(2015:May)
• Page Start: 796
• Page End: 802
• Publication Date: 2015-01-22
• Subjects: Alcoholism -- Periodicals; Drug addiction -- Periodicals; 616.86
• DOI: 10.1111/add.12836
• Languages: English
• ISSNs: 0965-2140

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="add12836-sec-0001" sec-type="section"> <title>Background and aims</title> <p>To decrease infectious disease transmission, China is expanding methadone maintenance treatment (MMT). This study evaluated the prevalence of hepatitis C virus (HCV) infection at MMT entry, seroconversion rates after admission and potential risk factors for HCV seroconversion during MMT in Wuhan, China.</p> </sec> <sec id="add12836-sec-0002" sec-type="section"> <title>Design</title> <p>Cross‐sectional survey of all patients entering MMT and prospective follow‐up of patients HCV seronegative at admission.</p> </sec> <sec id="add12836-sec-0003" sec-type="section"> <title>Setting</title> <p>All MMT clinics in Wuhan, China.</p> </sec> <sec id="add12836-sec-0004" sec-type="section"> <title>Participants</title> <p>A total of 12 755 opiate‐dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed.</p> </sec> <sec id="add12836-sec-0005" sec-type="section"> <title>Measurements</title> <p>Serological tests for HCV and self‐report data on risk behaviors at MMT admission; urine toxicology results and repeated assessments of serological status and risk behaviors during treatment on patients HCV seronegative at admission.</p> </sec> <sec id="add12836-sec-0006" sec-type="section"> <title>Findings</title> <p>HCV seroprevalence at admission was 72.1% [95% confidence interval (CI) = 71.3–72.9%] and 555/1200 (46.3%, 95% CI = 43.5–49.1%) patients seroconverted to HCV during MMT. The mean time to HCV seroconversion was 3 (95% CI = 2.84–3.07) years with a cumulative seroconversion rate of 34.5 (95% CI = 31.5–36.9) per 100 person‐years. Significant predictors of HCV conversion included injection drug use in the past 30 days [relative hazard (RH) 2.0, 95% CI: 1.6 – 2.4, <italic>P</italic>=0.002] and the rate of opiate‐positive urine tests during MMT (RH 2.0, 95% CI = 1.3–3.1, <italic>P</italic><0.001).</p> </sec> <sec id="add12836-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Methadone maintenance treatment patients in Wuhan, China show a high prevalence of hepatitis C virus at admission (72.1%) and a high rate of seroconversion during treatment (46.3%). Seroconversion is associated with continuing injection drug use.</p> </sec> </abstract>