Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Epidemiol Health. 2021;43:e2021077. doi: 10.4178/epih.e2021077. Epub 2021 Oct 6.
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).
We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).
Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.
As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.
注射毒品使用是丙型肝炎病毒（HCV）感染的一个主要危险因素；然而，韩国对此主题的数据有限。因此，本研究旨在调查注射吸毒者（PWID）中 HCV 感染的流行病学和临床特征、治疗的采用和结果。
我们使用了韩国 HCV 队列的数据，该队列在 2007 年至 2019 年期间前瞻性地招募了 HCV 感染患者。根据自我报告的 HCV 感染终生危险因素史，对临床数据和问卷调查结果进行了分析（PWID 组与非 PWID 组）。
在 2468 名患者中，有 166 名（6.7%）为 PWID 组，该组患者年龄更小（50.6±8.2 岁比 58.2±13.1 岁），男性比例更高（81.9%比 48.8%）。PWID 的分布存在显著的地区差异。两组 HCV 感染的其他危险因素分布不同。非 2 型基因型感染患者在 PWID 组中的比例较高。在干扰素时代，PWID 组的治疗采用率较高；然而，在直接作用抗病毒时代，两组之间的治疗采用率相当。持续病毒学应答率在两组之间无显著差异。
截至 2019 年，PWID 在韩国 HCV 感染者中占少数。PWID 组与非 PWID 组之间的流行病学特征不同，但治疗采用和结果并无差异。因此，韩国应向 PWID 提供积极的 HCV 筛查和治疗。
