International Journal of Epidemiology, Volume 33, Number 1, pp. 182-188
IJE vol.33 no.1 © International Epidemiological Association 2004; all rights reserved.
Infectious Diseases |
Rapid transmission of hepatitis C virus among young injecting heroin users in Southern China
1 Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
2 Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
3 Guangxi Centers for Disease Control and Prevention, Guangxi Province, China
4 Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, New York, USA
Correspondence: Xiao-Fang Yu, Associate Professor MMI, JHBSPH E5148, Baltimore, MD 21205, USA. Email: xfyu{at}jhsph.edu
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 >25 years (odds ratio [OR] = 1.71) and injection drug use for >2 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.
Keywords Hepatitis C, injection drug use, substance abuse, China, heroin, epidemiology, prevalence, risk factors, prevention, logistic model
Accepted 20 August 2003
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