| Objective To understand the HCV infection as well as the liver fibrosis progression among drug users in MMT clinics and analysis the factors influencing liver fibrosis.Methods From August to October,2016,a cross-sectional study was conducted among the HCV infected drug users in MMT clinics in Yunnan,Guangxi and Gansu Province.We investigate the rates of HCV and HCV infection,then recruited part of drug users whose HCV antibodies are positive,calculating APRI and FIB4 by AST,ALT and age,to analyse risk factors associated with liver fibrosis such sociodemographic characteristics,habit,treatment and HIV-HCV coinfection and so on.Result1.In the 6 MMT clinics,48.5%(1438/2962)of drug users were HCV antibody positive,9.7%(286/2962)HIV antibody positive,9.0%(268/2962)HIV-HCV co-infection.HIV prevalence among who were HCV-infected was 18.6%(268/1438),HCV prevalence among them HIV-infected was 93.7%(268/286).2.The average age of the 652 drug users recruited is 43.6±7.1 years old.Among them the male accounted for 84.2%(549/652),Han nationality 77.9%(508/652),education below junior middle school 72.1%(470/652),married 57.7%(376/652),unemployed 56.6%(369/652),income less than 100056.9%(371/652),more than 2000 26.1%(170/652).3.The duration of drug use of 32.7%(213/652)of clients were 20?24 years;84.4%(550/652)of them ever were IDUs;56.9%(371/652)of them never drink.4.The rate of answering all 10 questions rightly was 24.1%(157/652).91.9%participants once heard of hepatitis C.Over 65%clients knew the ways of HCV transmission.The rate of them knew harm of HCV was more than 80%but only about half of them knew hepatitis being curable.5.Among 652 HCV antibody positive participants,,24.1%(157/652)was significant fibrosis.11.3%(74/652)was F2 and F3.12.7%(83/652)was cirrhosis.6.Among 652 antibody positive participants,25.9%(169/652)once treated hepatitis C.10.0%(65/652)treated hepatitis C by antiviral therapy.The rates of HCV treatment and HCV treatment by antiviral therapy were 24.6%(122/495)and 10%(50/495)in participants who were no fibrosis,respecctively,29.7%(22/74)and 12.2%(9/74)in significant fibrosis and advanced fibrosis,30.1%(25/83)and 7.2%(6/83)in cirrhosis.7.The univariate logistic regression analysis reveal age beyonged 40 years(OR=2.0,95%CI:1.3-3.1),alcohol use(OR=1.6,95%CI:1.0-2.5)were associated with fibrosis.The multivariate regression analysis reveal duration of drug use(OR=6.5,95%CI:1.5-28.6)was independenty associated with fibrosis.Conclusions The anti-HCV positive rate of drug users in MMT clinic is higher than HIV,1/4 of them were unaware of their infection.The rate of treatment among participants is low.The real treated patients is less than the requisite ones.Duration of drug use can accelarate the liver fibrosis.Education about HCV knowledge,liver fibrosis testing and HCV treatment should be enhanced in MMT clinics.it is nessary to take manners helping the drug users rehabilitation. |
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