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. 2015 May;110(5):796-802.
doi: 10.1111/add.12836. Epub 2015 Jan 22.

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

Wang Zhou  1 , Xia Wang, Sheng Zhou, Nianhua Xie, Pulin Liu, Li Luo, Jinsong Peng, Manqing Liu, Alethea Desrosiers, Richard Schottenfeld, Marek C Chawarski
Affiliations

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

Wang Zhou et al. Addiction. 2015 May.

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.

Keywords: Behavioral risks; hepatitis C virus; injection drug use; methadone maintenance treatment; opiate dependence; seroconversion.

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Conflict of interest statement

Declaration of interests

None.

Figures

Figure 1
Figure 1
Cumulative rate of hepatitis C virus (HCV) seroconversion among methadone maintenance treatment (MMT) patients in Wuhan between May 2006 and December 2011
Figure 2
Figure 2
Hepatitis C virus (HCV) seroconversion rates among study participants who reported past 30-day injection drug use (IDU) and those who did not
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