Study On HCV Infection And Utilization Of Related Health Service In Methadone Maintenance Therapy Clinic

Objective To study the prevalence of HCV infection and utilization of hepatitis c-related services among clients in methadone maintenance treatment(MMT) clinics.And to investigate the factors associated with the utilization of HCV-related health services.Method A cross-sectional study to recruit clients in MMT clinic was conducted in Yunnan and Gansu Province by questionnaire, which includes sociodemographics,drug and alcohol use behavious,opiate substitution treatment,access to HCV service. We collected the recent HCV antibody (ab) and HIV ab testing outcomes of enrolled participants from MMT clinic managent system.Result1. We collected 618 questionnaires of clients in MMT clinics with the average age 4 1.8+8.9 years old.Among these clients,the male accounted for 86.1%(532/618),Han nationality 80.6%(498/618)junior high school education 62.6%(387/618),living with family/friends 80.4%(519/618),people with monthly income less than 1000 38.3%(237/ 618),more than 2000 44.8%(277/618)joining medical insurance 85.1(526/618).2. Accroding to recent HCV ab and HIV ab testing results recorded in MMT clinic management system,54.2%(335/618)of participants were HCV ab positive,14.9%(92/618) HIV ab positive,14.2%(88/618) HIV/HCV co-infected. HIV prevalence in HCV-infected people was 6.3%(88/335),HCV prevalence in HIV-infected people was 95.7%(88/92)。3. The duration of drug use of 24.6%(152/618) of clients in MMT clinics were 15-20 year; 53.9%(333/618) of participants ever used drug by injection; 57.8%(357/618) of participants were low risk alcohol use;4. The correct respond rate of all participants was 12.5%(77/618).95.7% of participants had heard of hepatitis C,more than half participants knew transmission of HCV,the rate of people knew harm and treatment information of HCV was less than half.HCV-infected participants had greater knowledge than those were not infected.(χ2=29.52,P<0.0001).5. Among 335 participants infected with HCV,74.6%(250/335) were aware of their status, 34.9%(117/335) had the experience of seeing a doctor for their HCV treatment,15.2% (51/335)had tested HCV RNA,13.4%(45/335)had taken HCV treatment with interferon,3.0% (10/335) had cured.6. Among 250 participants who were aware of their status,46.8%(117/335) had seen a doctor for their HCV infection.Those were in Dehong clinic(OR=3.3,95%C7:1.7～6.5), lived with family/friends(OR=6.1,95%CI:2.3-16.5), had greater HCV knowledge(OR= 4.6,95%CI:1.9-10.9), having been told to go onto HCV treatment at the first time knowing anti-HCV positive(OR=8.5,95%CI:4.2-17.1), with HCV-related symptoms and signs(OR=5.0,95%CI:2.5-10.0) had been more likely to see a doctor for their HCV infection.7. Among 250 participants who were aware of their status,27.2%(68/250) had taken HCV treatment.Factors were significantly associated with HCV treatment including in Dehong clinic(OR=4.8,95%CI:2.3-10.1), high education level(OR=7.6,95% CI:1.7-34.3),living with family/friends(OR=14.2,95%CI:2.4-83.3), having been told to go onto HCV treatment at the first time knowing anti-HCV positive(OR=6.0,95%CI:2.7-13.3), and with HCV-related symptoms and signs(OR=5.2,95%CI:2.6-10.5).Conclusion More than half of clients in MMT clinic were anti-HCV positive, but 1/4 of seropositive participants were unaware of their infection. Of 250 participants who were aware of their status,less than half had seen a doctor for their HCV.even fewer participants had received HCV treatment.The high prevalence of HCV and low utilization of HCV services among clients in MMT clinics emphasized an urgent need to improve related strategy and work.According to our study,factors incliding high education level, living with family/friends, had greater HCV knowledge, having been told to go onto HCV treatment at the first time knowing anti-HCV positive, with HCV-related symptoms and signs and local exemption to medicine charge were significantly associated with utilization of HCV-related services.Educaton about HCV knowledge among clients and medical staff in MMT clinics,HCV referral services,sign monitor should be strengthened. We can take use of the platform which has established for AIDS prevention and control to carry out the HCV related prevention and treatment.