Xiaoli Wei, Lirong Wang, Xueliang Wang, Jinsong Li, Hengxin Li, Wei Jia
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China ; Xi'an Center for Disease Control and Prevention, Xi'an, China.
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Hepat Mon. 2014 Nov 23;14(11):e19601. doi: 10.5812/hepatmon.19601. eCollection 2014 Nov.
Hepatitis C virus (HCV) infection rates in drug users vary among different regions of China. Drug users who are unaware of their HCV serostatus tend to engage in more risky behaviors.
This prospective study aimed to assess risk factors of HCV infection in drug users among 11 methadone maintenance treatment (MMT) clinics in Xi'an, China.
Baseline characteristics and drug use information of patients were collected upon enrollment in the study and anti-HCV tests were performed within one month after the enrollment. Data on daily medication, monthly random urine morphine test results, illicit drug use and MMT retention time were recorded during a 5-year follow-up.
Of 10243 patients, 58.0% had positive results for anti-HCV. Injection drug use, longer duration of drug abuse, older age, female gender, unmarried status and unemployment were independent risk factors of HCV infection. Urine test positivity rate was lower (14.8% vs. 16.7%, χ(2) = 100.235, P < 0.05), but MMT retention rate was higher (log-rank χ(2) = 4.397, P < 0.05) in the anti-HCV positive group than anti-HCV negative one. However, multivariate regression revealed no significant association between anti-HCV serostatus and either MMT retention time or illicit drug use.
The major risk factor of HCV infection was injection drug use. The patient's awareness of his or her HCV status had a minor effect in reduction of illicit drug use and improvement in MMT retention. Therefore, adequate counseling is necessary for drug users in MMT clinics in Xi'an.
中国不同地区吸毒者的丙型肝炎病毒（HCV）感染率有所不同。未意识到自身HCV血清学状态的吸毒者往往会有更多危险行为。
这项前瞻性研究旨在评估中国西安11家美沙酮维持治疗（MMT）诊所吸毒者HCV感染的危险因素。
在研究入组时收集患者的基线特征和吸毒信息，并在入组后1个月内进行抗HCV检测。在5年随访期间记录每日用药情况、每月随机尿吗啡检测结果、非法药物使用情况和美沙酮维持治疗留存时间。
10243例患者中，58.0%抗HCV检测呈阳性。注射吸毒、吸毒时间较长、年龄较大、女性、未婚状态和失业是HCV感染的独立危险因素。抗HCV阳性组尿检测阳性率较低（14.8%对16.7%，χ(2)=100.235，P<0.05），但美沙酮维持治疗留存率较高（对数秩χ(2)=4.397，P<0.05）。然而，多因素回归显示抗HCV血清学状态与美沙酮维持治疗留存时间或非法药物使用之间无显著关联。
HCV感染的主要危险因素是注射吸毒。患者对自身HCV状态的知晓在减少非法药物使用和提高美沙酮维持治疗留存率方面作用较小。因此，西安美沙酮维持治疗诊所的吸毒者需要进行充分的咨询。
