Prevalence and characterization of hepatitis B and C virus infections in a needle-sharing population in Northern China

Abstract

BackgroundThe epidemiologies of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in specific populations in certain areas of China are poorly understood. A pilot survey of HCV/HBV infections was carried out in villages in Kuancheng County, Heben Province, where injection of sodium benzoate or amphetamines using shared needles has been a common practice. The aims of this study were to analyze the endemicity and characterize HCV/HBV infections in this population.MethodsData on demographic characteristics and drug abuse were collected from individuals who signed informed consent forms. Serum HCV antibody (anti-HCV), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc) were measured in all participants. HCV RNA was measured in samples positive for anti-HCV using real-time polymerase chain reaction.ResultsAmong 852 participants from 11 villages, 49.9% had used sodium benzoate or amphetamine at least once, by intravenous injection. The overall prevalence of anti-HCV, HCV RNA, anti-HBc, HBsAg, and HCV/HBV co-infection was 37.1%, 26.6%, 67.7%, 10.7%, and 30.0%, respectively. Two-hundred-twenty-three of 227 (98.2%) participants positive for HCV RNA were aged >40 years. Co-infection was related to sex, age, number of injections, and time from first injection. The rate of spontaneous HCV RNA clearance was 28.2% (89/316), and was related to the number of injections, time from first injection, and HBsAg positivity. However, HBsAg was related to the anti-HBc signal/cut-off ratio rather than to the above parameters. Trend tests demonstrated that the prevalence of anti-HCV, HCV RNA, and anti-HBc was related to the number of injections (P < 0.001), while HBsAg prevalence was not (P = 0.347).ConclusionsThe prevalence of HCV and HBV infection is likely to be high among individuals older than 40 years in areas of needle sharing, and one-time screening for HCV infection should be offered to these populations.

HCV genotype 6 prevalence, spontaneous clearance and diversity among elderly members of the Li ethnic minority in Baisha County, China

“…Compared to a population of Chinese chronically HCV‐infected subjects, the significantly lower viral load observed in the Li population provides indirect evidence to support a higher spontaneous clearance rate which would correlate with a previous study . No significant association was found with gender in our study, although it has been well established that women are more likely to clear HCV than males . However, three other studies, including US injection drug users, US blood donors and the Italian general population, also found no significant association of HCV clearance with gender .…”

“…39 No significant association was found with gender in our study, although it has been well established that women are more likely to clear HCV than males. 41,43,44,47 However, three other studies, including US injection drug users, US blood donors and the Italian general population, also found no significant association of HCV clearance with gender. 48 One possible interpretation for these differing results is that the association with gender may be confounded by tattooing, the probable route of HCV transmission in Baisha County, which is practised significantly more in females than males as discussed The reason for this discrepancy could be the distinct geographical location of Li and Han populations or a lack of interaction between the groups.…”

“…HCV spontaneous clearance of 18% occurred in children in a contemporary US cohort after 6 months of infection . Two recent studies from north and southwest China involving a limited number of patients with acute HCV infection reported recovery rates of 28.2% and 30.2% . The Irish Hepatology Research Group revealed that there was up to 50% recovery among a population of Irish women who were exposed to HCV‐contaminated anti‐D immune globulin .…”

Risk behaviours related to hepatitis B virus infection among adults in Malaysia: A cross-sectional household survey

“…3 Several risk factors for horizontal transmission have been identified such as history of dental procedures [4][5][6][7] or surgical interventions, 4,5,8,9 blood transfusions, 4,8,10 hemodialysis, 11 and history of abrasions during haircuts. 12 Certain groups also have a higher risk of HepB for example men who have sex with men, 13,14 drug and alcohol users, 4,[15][16][17][18][19][20] healthcare workers, [21][22][23][24][25][26] household members who live with a HepB carrier, 11,27,28 and individuals with multiple sexual partners. 24,29 In addition, HepB prevalence is higher among people who having been tattooed, 4,9,20,30 who have piercings 8 and who share household tools such as toothbrushes, razor blades and nail cutters.…”

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

“…These are crude estimates with significant differences in prevalence, from 2.0 % in South East Asia to 3.7-3.8 % in East and Central Asia [89], and the highest of approximately 15 % in Egypt [90]. The prevalence of hepatitis C infection varies significantly in different areas and different populations among or within countries, implying different routes of transmission and different strategies needed to prevent HCV transmission [91,92].…”