Seroepidemiology of Hepatitis C Among Drug Users at a Detoxification Center in Southeast China

Background: Hepatitis C virus (HCV) infection is prevalent worldwide, especially among drug users. The epidemiology of HCV is rarely reported among drug users in developing countries, including China. Objectives: We aimed to describe the seroepidemiology of HCV infection in drug users at a Detoxification Center in Southeast China. Methods: With approval from the Shantou Center for Disease Control, the archived data of drug users (n = 5,228) at the largest monitored-detoxification center in Shantou during 2011 - 2017 were analyzed for demographics, risk behaviors, and HCV serology. Results: Among HCV-tested drug users, 36.9% (1930/5228) were people who inject drugs (PWID). The mean annual HCV seroprevalence rate over the seven-year study period was 36.3% for all drug users, including 67.3% and 16.6% for PWID and non-PWID, respectively, with the highest prevalence (78.1%) in 2017 and the lowest prevalence (58.6%) in 2015 for PWID. Independent risk factors of HCV infection identified by multiple logistic regression analysis were engaging in unprotected sex (OR=1.553, 95% CI =1.078 -2.236), injecting drugs (10.28, 8.98 -11.763), and sharing needles/syringes (2.24,1.129 - 4.445) for all drug users and sharing needles/syringes (2.062,1.438 - 2.957) for PWID. Conclusions: This study reports the seroepidemiology of drug users in the monitored Detoxification Center in Southeast China. A relatively high HCV positivity rate, especially among PWID, their high-risk behaviors and low education, and lack of institutional interventions of HCV monitoring and transmission call for government-sponsored educational programs to raise drugusers' awareness of the risk of HCV infection and other co-infections and monitoring of the infectious status and treatment of HCV-infected drug users.