title: Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China.
abstract: OBJECTIVE
  To decrease infectious disease transmission, China is expanding methadone maintenance treatment (MMT). This study evaluated the prevalence of hepatitis C virus (HCV) infection at MMT entry, seroconversion rates after admission and potential risk factors for HCV seroconversion during MMT in Wuhan, China.
  
  
  METHODS
  Cross-sectional survey of all patients entering MMT and prospective follow-up of patients HCV seronegative at admission.
  
  
  METHODS
  All MMT clinics in Wuhan, China.
  
  
  METHODS
  A total of 12 755 opiate-dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed.
  
  
  METHODS
  Serological tests for HCV and self-report data on risk behaviors at MMT admission; urine toxicology results and repeated assessments of serological status and risk behaviors during treatment on patients HCV seronegative at admission.
  
  
  RESULTS
  HCV seroprevalence at admission was 72.1% [95% confidence interval (CI) = 71.3-72.9%] and 555/1200 (46.3%, 95% CI = 43.5-49.1%) patients seroconverted to HCV during MMT. The mean time to HCV seroconversion was 3 (95% CI = 2.84-3.07) years with a cumulative seroconversion rate of 34.5 (95% CI = 31.5-36.9) per 100 person-years. Significant predictors of HCV conversion included injection drug use in the past 30 days [relative hazard (RH) 2.0, 95% CI: 1.6 - 2.4, P=0.002] and the rate of opiate-positive urine tests during MMT (RH 2.0, 95% CI = 1.3-3.1, P<0.001).
  
  
  CONCLUSIONS
  Methadone maintenance treatment patients in Wuhan, China show a high prevalence of hepatitis C virus at admission (72.1%) and a high rate of seroconversion during treatment (46.3%). Seroconversion is associated with continuing injection drug use.
authors.affiliation: Wuhan Center for Disease Control and Prevention, Wuhan, Hubei, PR China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhou
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhou
authors.forename: Nianhua
authors.initials: N
authors.lastname: Xie
authors.forename: Pulin
authors.initials: P
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.forename: Jinsong
authors.initials: J
authors.lastname: Peng
authors.forename: Manqing
authors.initials: M
authors.lastname: Liu
authors.forename: Alethea
authors.initials: A
authors.lastname: Desrosiers
authors.forename: Richard
authors.initials: R
authors.lastname: Schottenfeld
authors.forename: Marek C
authors.initials: MC
authors.lastname: Chawarski
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000097:blood / Q000534:rehabilitation*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D000069078:Seroconversion; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000534:rehabilitation*
chemical_list: D008691:Methadone
keywords: Behavioral risks; hepatitis C virus; injection drug use; methadone maintenance treatment; opiate dependence; seroconversion