High Prevalence of HIV, HCV and Tuberculosis and Associated Risk Behaviours among New Entrants of Methadone Maintenance Treatment Clinics in Guangdong Province, China

Abstract

BackgroundMethadone maintenance treatment (MMT) has been available in Guangdong province, China since 2006. This study aims to estimate the prevalence levels of HIV, Hepatitis C (HCV), Tuberculosis (TB) and their co-infections and associated demographic and risk behaviours among MMT entrants.MethodA total of 2296 drug users at the time of their MMT enrolment were recruited from four clinics during 2006-2011. Participants’ demographic characteristics, infection status and self-reported high-risk drug-use and sexual behaviours were surveyed. Log-linear contingency analysis was employed to investigate the demographic and behavioural differences between gender and drug-user type, while multivariate regression analysis was used to identify the associated factors of HIV, HCV and TB infections.ResultsFemale drug users demonstrate significantly higher frequency of daily drug consumption (Log-linear contingency analysis, G2=10.86, p=0.013) and higher proportion of having had sex in the past three months (G2=30.22, p<0.001) than their male counterparts. Among injecting drug users, females also inject (χ2=16.15, p=0.001) and share syringes (χ2=13.24, p=0.004) more frequently than males. Prevalence of HIV, HCV and TB among MMT entrants are 6.3%, 78.7% and 4.4% respectively. Co-infections of HIV/HCV, HIV/TB, HCV/TB and HIV/HCV/TB reportedly infect 5.6%, 0.5%, 3.8% and 0.3% of study participants. Infection risks of HIV, HCV and TB are consistently associated with increasing length of drug use, injecting drugs, financial dependence and reduced sexual activities.ConclusionInjecting drug use is the major contributing factor in prevalence levels of HIV, HCV and TB among MMT entrants. Female drug users are more disadvantaged in their social status and risk-taking in their drug use behaviours than males.

Prevalence of hepatitis C virus in young people who inject drugs in four Colombian cities: A cross-sectional study using Respondent Driven Sampling

“…In agreement with previous studies (Holtzman et al, 2009; Miller, Hellard, Bowden, Bharadwaj, & Aitken, 2009; Reyes et al, 2006; Zamani et al, 2010; Zhang et al, 2013; Zhou et al, 2012), we found that PWID with history of injection drug use of two to four years in Armenia, and 5 or more years in Pereira, were at higher risk of being HCV seropositive. In the context of our sample, this finding should not be underestimated given the fact that around 54% of all PWID in our study reported a history of injection drug use of 4 years or less, suggesting that it’s a population with short history of injection drug use.…”

“…Risky injection behaviors – such as assisted injection, and needle and drug-preparation equipment sharing – have been previously associated to increased risk of infection with HCV and human immunodeficiency virus (HIV) (Hagan & Des Jarlais, 2000; Hagan et al, 2001; Mathei et al, 2006; Nelson et al, 2011; Thiede, 2001). Moreover, longer duration of injection, increased frequency of injection, HIV seropositive status, and injecting with other people, have been directly associated to a greater risk of transmission and reduced time to primary HCV infection (Hickman et al, 2007; Lopes et al, 2009; Rolls et al, 2013; Rondy et al, 2013; Zhang, Zhang, Chen, Zou, & Ling, 2013; Zhou et al, 2012). …”

Role of Hepatitis B and Hepatits C Virus Coinfection in Tb Development

“…This means that patients are 2.7 times more likely to have a history of hepatitis B infection, rather than control. This finding is consistent with research findings in China at risk groups of drug users who find an odd ratio was higher in coinfection Hepatitis virus (Zhang et al 2013). Another study, still in China, also found the risk of clinical manifestations of tuberculosis increased in the group with oncogenic HPV infection (Graubard et al 2011).…”

Investigation of Repeat Client Drop-Out and Re-Enrolment Cycles in Fourteen Methadone Maintenance Treatment Clinics in Guangdong, China

“…Guangdong is one of the most economically developed provinces in Southern China and has more than 370,000 drug users, accounting for about one-sixth of all registered drug use in China [ 28 ]. The latest statistics indicated that 6.3%, 78.7% and 4.4% of drug users are infected with HIV, HCV and Tuberculosis (TB) in 2013, respectively [ 29 ]. A total of 61 MMT clinics have been established since the programme initiation in 2006.…”