Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China.

Abstract

BACKGROUND AND AIMS:

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.

DESIGN:

Cross-sectional survey of all patients entering MMT and prospective follow-up of patients HCV seronegative at admission.

SETTING:

All MMT clinics in Wuhan, China.

PARTICIPANTS:

A total of 12 755 opiate-dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed.

MEASUREMENTS:

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.

FINDINGS:

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, P=0.002] and the rate of opiate-positive urine tests during MMT (RH 2.0, 95% CI = 1.3-3.1, P<0.001).

CONCLUSIONS:

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.

• Authors: Wang Zhou, Xia Wang, Sheng Zhou, Nianhua Xie, Pulin Liu, Li Luo, Jinsong Peng, Manqing Liu, Alethea Desrosiers, Richard Schottenfeld, Marek C Chawarski
• Journal: Addiction (Abingdon, England) (Addiction) Vol. 110 Issue 5 Pg. 796-802 (May 2015) ISSN: 1360-0443 [Electronic] England
• PMID: 25529103 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 Society for the Study of Addiction.

Chemical References

• Methadone

Topics

• Adult
• China (epidemiology)
• Cross-Sectional Studies
• Female
• Hepatitis C (blood, epidemiology)
• Humans
• Male
• Methadone (therapeutic use)
• Opiate Substitution Treatment
• Opioid-Related Disorders (blood, rehabilitation)
• Prevalence
• Prospective Studies
• Risk Factors
• Seroconversion
• Seroepidemiologic Studies
• Substance Abuse, Intravenous (blood, rehabilitation)