Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 28, 2013; 19(32): 5320-5325
Published online Aug 28, 2013. doi: 10.3748/wjg.v19.i32.5320
Prevalence of hepatitis C infection among intravenous drug users in Shanghai
Yan-Lin Tao, Yu-Fan Tang, Jian-Ping Qiu, Xiao-Feng Cai, Xiao-Ting Shen, Ya-Xin Wang, Xue-Tao Zhao
Yan-Lin Tao, Yu-Fan Tang, Xiao-Feng Cai, Xiao-Ting Shen, Ya-Xin Wang, Xue-Tao Zhao, Microbiology Laboratory, Center for Disease Control and Prevention of Xuhui, Shanghai 200237, China
Jian-Ping Qiu, Microbiology Laboratory, Shanghai Public Health Clinical Center, Shanghai 200083, China
Author contributions: Tao YL and Tang YF carried out the screening tests for antibodies to hepatitis C virus, Recombinant immunoblot assay, and Qualitative tests for hepatitis C virus RNA; Qiu JP, Cai XF, Shen XT and Wang YX participated in the screening tests for antibodies to hepatitis C virus and sample assembly; Zhao XT designed this study, performed the statistical analysis and wrote the paper; all authors read and approved the final manuscript.
Supported by Science and Technology Commission Xuhui District and Xuhui Health Bureau of Shanghai, No. SHXH201226
Correspondence to: Xue-Tao Zhao, MPH, Microbiology Laboratory, Center for Disease Control and Prevention of Xuhui, 50 Yongchuan Road, Xuhui District, Shanghai 200237, China. zhaoxtc@gmail.com
Telephone: +86-21-54012590 Fax: +86-21-54012590
Received: April 24, 2013
Revised: July 15, 2013
Accepted: July 18, 2013
Published online: August 28, 2013
Processing time: 124 Days and 20.6 Hours
Abstract

AIM: To characterize the prevalence of hepatitis C virus (HCV) infection among Chinese intravenous drug users (IDUs).

METHODS: A total of 432 adult IDUs (95 women and 337 men) in Shanghai were included in the study. The third-generation Elecsys Anti-HCV assay (Roche Diagnostics GmbH, Sandhofer Strasse 116, D-68305, Mannheim, Germany) was used to screen for antibodies against HCV. The RIBA strip, a supplemental anti-HCV test with high specificity, was performed on all of the samples that tested positive during the initial screening. All of the anti-HCV positive samples were analyzed with a Cobas TaqMan 48 Analyzer (Roche Diagnostics) for direct detection of HCV RNA. All of the HCV RNA-positive samples were sequenced for genotype determination.

RESULTS: The preliminary screening identified 262 (60.6%) subjects who were seropositive for HCV. Of the 62 females and 200 males seropositive subjects, 16 (16.7%) and 65 (19.3%), respectively, were confirmed by RIBA, yielding an overall HCV seropositive rate of 18.8%. Four female (6.5%) and 14 male (7.0%) subjects tested positive for HCV RNA, indicating an active infection rate of 4.2% for the entire study population. The 18 HCV RNA-positive serum samples were genotyped. Seven individuals were genotype 1b, and four were genotype 1a. One individual each was infected with genotypes 2a, 2b and 3a. Four subjects were co-infected with multiple strains: two with genotypes 1a and 2a, and two with genotypes 1b and 2a. The active infection rate among HCV-seropositive individuals was 22.2%, which was significantly lower than most estimates.

CONCLUSION: The prevalence of HCV is relatively low among IDUs in Shanghai, with a spontaneous recovery rate much higher than previous estimates.

Keywords: Hepatitis C; Anti-hepatitis C virus antibodies; Prevalence of hepatitis C virus; Active infection rate; Intravenous drug users

Core tip: In this report, we examined the prevalence of anti-hepatitis C virus (HCV) antibodies, as well as chronic viremia, in 432 intravenous drug users (IDUs) in Shanghai, China. Our data will facilitate the characterization of the prevalence of HCV infection among Chinese IDUs and will complement our understanding of the natural course of HCV infections.