Hepatitis C virus infection among injection drug users with and without human immunodeficiency virus co-infection.
The aim of this study is to explore the prevalence of hepatitis C virus (HCV) infection among injection drug users (IDUs) with and without human immunodeficiency virus (HIV) infection in southern Taiwan. For 562 IDUs (265 anti-HIV negative, 297 anti-HIV positive), we analyzed liver function, anti-HIV antibody, anti-HCV antibody, HCV viral loads, and hepatitis B surface antigen (HBsAg). HIV RNA viral loads and CD4 cell count for anti-HIV-seropositive IDUs and the HCV genotype for HCV RNA-seropositive IDUs were measured. The seroprevalence rates of anti-HIV, anti-HCV, and HBsAg were 52.8%, 91.3%, and 15.3%, respectively. All the anti-HIV-seropositive IDUs were positive for HIV RNA. Anti-HCV seropositivity was the most important factor associated with HIV infection (odds ratio [OR], 25.06; 95% confidence intervals [CI], 8.97-74.9), followed by male gender (OR, 6.12; 95% CI, 4.05-9.39) and HBsAg seropositivity (OR, 1.90; 95% CI, 1.11-3.34). Among IDUs positive for anti-HCV, 80.7% had detectable HCV RNA. HCV viremia after HCV exposure was strongly related to HIV infection (OR, 6.262; 95% CI, 1.515-18.28), but negatively correlated to HBsAg seropositivity (OR, 0.161; 95% CI, 0.082-0.317). HCV genotype 6 was the most prevalent genotype among all IDUs (41.0%), followed by genotypes 1 (32.3%), 3 (12.8%), and 2 (5.6%). In conclusion, about half IDUs were infected with HIV and >90% with HCV infection. Male and seropositivity for HBsAg and anti-HCV were factors related to HIV infection among our IDUs. HIV was positively correlated, whereas hepatitis B co-infection was negatively correlated with HCV viremia among IDUs with HCV exposure. Different HCV molecular epidemiology was noted among IDUs.
Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Meng-Hsuan
MH
Hsieh
Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City,Taiwan.
Jih-Jin
JJ
Tsai
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Ming-Yen
MY
Hsieh
Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan.
Chung-Feng
CF
Huang
Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Ming-Lun
ML
Yeh
Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Jeng-Fu
JF
Yang
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan.
Ko
K
Chang
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Wei-Ru
WR
Lin
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Chun-Yu
CY
Lin
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Tun-Chieh
TC
Chen
Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan.
Jee-Fu
JF
Huang
Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Chia-Yen
CY
Dai
Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Ming-Lung
ML
Yu
Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Hepatitis Center and Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Wan-Long
WL
Chuang
D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D015897:Comorbidity; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000276:immunology; D006801:Humans; D008297:Male; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000276:immunology; D013624:Taiwan / Q000453:epidemiology; D019562:Viral Load
D018937:Hepatitis C Antibodies