Sugiyama Aya, Kagaya Ariyuki, Ko Ko, Phyo Zayar, Akuffo Golda Ataa, Akita Tomoyuki, Takahashi Kazuaki, Tsukue Ryotaro, Shimohara Chika, Tanaka Junko
Department of Epidemiology, Infectious Disease Control and Prevention Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Project Research Center for Epidemiology and Prevention of viral hepatitis and hepatocellular carcinoma, Hiroshima University, Hiroshima, Japan.
GHM Open. 2024 Jul 31;4(1):1-10. doi: 10.35772/ghmo.2023.01017.
Towards the WHO goal for hepatitis elimination, understanding the prevalence and management of hepatitis B and C viruses (HBV, HCV) among drug abusers is crucial. However, in Japan, where drug abuse is less prevalent than in other countries, there is a dearth of epidemiological studies on this topic. This study aimed to fill this gap by investigating virus prevalence and the testing and treatment landscape for drug abusers in Japan. We conducted a cross-sectional sero-epidemiological study at a psychiatric hospital in Hiroshima where approaching drug abusers was feasible. Blood samples and questionnaire on HBV/HCV testing and treatment were collected from drug abusers ( = 35, 85.7% male, mean age 55.4 years) and control group ( = 45, 71.1%, 48.2 years). Prevalence of HCV-Ab and HCV RNA in drug abusers was 60.0% (95% CI: 43.8-76.2%) and 28.6% (13.6-43.5%), respectively, which was significantly higher than in the control group (2.2%, 0.0%, respectively). All HCV-Ab positive drug abusers had undergone prior hepatitis virus testing, but only 42.9% of those eligible for HCV treatment were connected to it. For HBV, while prevalence of HBsAg was similar between groups (2.9% . 2.2%), prevalence of HBc-Ab was higher in drug abusers (34.3% 17.8%), indicating a greater likelihood of exposure to HBV infection. In conclusion, HCV prevalence among drug abusers in psychiatric care is notably high. Although testing is accessible, a recognized challenge is the insufficient connection to treatment. Enhancing collaboration between psychiatric hospitals and hepatologists is crucial. Disregarding this issue is not an option for hepatitis elimination.
为实现世界卫生组织消除肝炎的目标，了解药物滥用者中乙型和丙型肝炎病毒（HBV、HCV）的流行情况及管理至关重要。然而，在日本，药物滥用情况不如其他国家普遍，关于这一主题的流行病学研究匮乏。本研究旨在通过调查日本药物滥用者的病毒流行情况以及检测和治疗现状来填补这一空白。我们在广岛的一家精神病医院开展了一项横断面血清流行病学研究，在该医院接触药物滥用者是可行的。从药物滥用者（n = 35，85.7%为男性，平均年龄55.4岁）和对照组（n = 45，71.1%为男性，平均年龄48.2岁）收集了血液样本以及关于HBV/HCV检测和治疗的问卷。药物滥用者中HCV-Ab和HCV RNA的流行率分别为60.0%（95%CI：43.8 - 76.2%）和28.6%（13.6 - 43.5%），显著高于对照组（分别为2.2%和0.0%）。所有HCV-Ab阳性的药物滥用者之前都接受过肝炎病毒检测，但 eligible for HCV treatment were connected to it. For HBV, while prevalence of HBsAg was similar between groups (2.9% . 2.2%), prevalence of HBc-Ab was higher in drug abusers (34.3% 17.8%), indicating a greater likelihood of exposure to HBV infection. In conclusion, HCV prevalence among drug abusers in psychiatric care is notably high. Although testing is accessible, a recognized challenge is the insufficient connection to treatment. Enhancing collaboration between psychiatric hospitals and hepatologists is crucial. Disregarding this issue is not an option for hepatitis elimination.（这段英文原文似乎有误，翻译如下：在符合丙型肝炎治疗条件的患者中，只有42.9%的人接受了治疗。对于HBV，虽然两组之间HBsAg的流行率相似（2.9%对2.2%），但药物滥用者中HBc-Ab的流行率更高（34.3%对17.8%），这表明感染HBV的可能性更大。总之，精神科护理中的药物滥用者中HCV流行率显著较高。虽然检测是可行的，但一个公认的挑战是治疗衔接不足。加强精神病医院和肝病专家之间的合作至关重要。忽视这个问题对于消除肝炎来说不是一个可行的选择。）
