Epidemiology and Health

Original Articles

Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID: Kyung-Ah Kim, Gwang Hyun Choi, Eun Sun Jang, Young Seok Kim, Youn Jae Lee, In Hee Kim, Sung Bum Cho, Moran Ki, Hwa Young Choi, Dahye Paik, Sook-Hyang Jeong; Epidemiol Health. 2021;43:e2021077. Published online October 6, 2021; DOI: https://doi.org/10.4178/epih.e2021077

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Abstract

OBJECTIVES
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).

METHODS

We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).

RESULTS

Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.

CONCLUSIONS

As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.

Summary

Korean summary
1. 국내 C형간염 환자 중 정맥주사 사용자의 비율은 6.7%로 서구에 비하면 낮은 편이며, 지역별로 차이가 있다. 2. C형간염 환자 중 정맥주사 사용자는 비사용자에 비하여 연령, 성별 및 C형간염 위험 요인 노출 등에서 상이한 역학적 특성을 보인다. 3. 정맥주사 사용자의 C형간염 치료 수용률이나 치료 성공률은 비사용자와 비슷하다.

Key Message
As of 2019, PWID comprised a minority (6.7%) of all HCV-infected people in South Korea. The epidemiological features of the PWID group were different from those of the non-PWID group in terms of age, sex and exposure to risk factors of HCV infection. However, the treatment uptake and outcomes were not significantly different between these 2 groups in DAA era. Therefore, considering the global and national increase in the number of PWID and the contribution of PWID to new cases of HCV infection, active screening and treatment should be offered to PWID in Korea.

Citations

Citations to this article as recorded by

Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study
Sun He, Gao Shuang, Wu Yinglan, Wang Lan, Wang Wei, Wang Ailing, Wang Changhe, Wang Xiaoyan, Gao Qun, Lu Zechun, Huang Dongxu, Wang Yu, Mo Phoenix Kit Han, Chen Zhongdan, Polin Chan, Wang Qian
Scientific Reports.2023;[Epub] CrossRef
Hepatitis C Virus Seroprevalence in Persons Who Inject Drugs in Korea, 2012–2022: A Multicenter, Retrospective Study
Jihye Kim, Gwang Hyeon Choi, Og-Jin Jang, Younghoon Chon, Sung Nam Cho, Dohoon Kwon, Sook-Hyang Jeong
Journal of Korean Medical Science.2023;[Epub] CrossRef

Decomposing economic disparities in risky sexual behaviors among people who inject drugs in Tehran: Blinder-Oaxaca decomposition analysis: Mehdi Noroozi, Hamid Sharifi, Alireza Noroozi, Fatemah Rezaei, Mohammad Rafi Bazrafshan, Bahram Armoon; Epidemiol Health. 2017;39:e2017049. Published online November 5, 2017; DOI: https://doi.org/10.4178/epih.e2017049

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Abstract PDF: Abstract
OBJECTIVES
To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.
METHODS
Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.
RESULTS
Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.
CONCLUSIONS
Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.; Summary

Estimation of the Frequency of Intravenous Drug Users in Hamadan City, Iran, Using the Capture-recapture Method: Salman Khazaei, Jalal Poorolajal, Hossein Mahjub, Nader Esmailnasab, Mohammad Mirzaei; Epidemiol Health. 2012;34:e2012006. Published online October 31, 2012; DOI: https://doi.org/10.4178/epih/e2012006

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>The number of illicit drug users is prone to underestimation. This study aimed to use the capture-recapture method as a statistical procedure for measuring the prevalence of intravenous drug users (IDUs) by estimating the number of unknown IDUs not registered by any of the registry centers.</sec><sec><title>METHODS</title>This study was conducted in Hamadan City, the west of Iran, in 2012. Three incomplete data sources of IDUs, with partial overlapping data, were assessed including: (a) Volunteer Counseling and Testing Centers (VCTCs); (b) Drop in Centers (DICs); and (c) Outreach Teams (ORTs). A log-linear model was applied for the analysis of three-sample capture-recapture results. Two information criteria were used for model selection including Akaike's Information Criterion and the Bayesian Information Criterion.</sec><sec><title>RESULTS</title>Out of 1,478 IDUs registered by three centers, 48% were identified by VCTCs, 32% by DICs, and 20% by ORTs. After exclusion of duplicates, 1,369 IDUs remained. According to our findings, there were 9,964 (95% CI, 6,088 to 17,636) IDUs not identified by any of the centers. Hence, the real number of IDUs is expected to be 11,333. Based on these findings, the overall completeness of the three data sources was around 12% (95% CI, 7% to 18%).</sec><sec><title>CONCLUSION</title>There was a considerable number of IDUs not identified by any of the centers. Although the capture-recapture method is a useful and practical approach for estimating unknown populations, due to the assumptions and limitations of the method, the results must be interpreted with caution.</sec>

Summary

Citations

Citations to this article as recorded by

The prevalence of opioid use disorder in Kentucky’s counties: A two-year multi-sample capture-recapture analysis
Katherine Thompson, Joshua A. Barocas, Chris Delcher, Jungjun Bae, Lindsey Hammerslag, Jianing Wang, Redonna Chandler, Jennifer Villani, Sharon Walsh, Jeffery Talbert
Drug and Alcohol Dependence.2023; 242: 109710. CrossRef
Estimating the Population Size of Female Sex Worker Population in Tehran, Iran: Application of Direct Capture–Recapture Method
Manoochehr Karami, Salman Khazaei, Jalal Poorolajal, Alireza Soltanian, Mansour Sajadipoor
AIDS and Behavior.2017; 21(8): 2394. CrossRef
Using the capture-recapture method to estimate the human immunodeficiency virus-positive population
Jalal Poorolajal, Younes Mohammadi, Farzad Farzinara
Epidemiology and Health.2017; 39: e2017042. CrossRef
Estimation of perinatal mortality rate for institutional births in Rajasthan state, India, using capture-recapture technique
P. K. Mony, B. Varghese, T. Thomas
BMJ Open.2015; 5(3): e005966. CrossRef
Estimating the size of the population of persons who inject drugs in the island of Montréal, Canada, using a six-source capture–recapture model
Pascale Leclerc, Alain C. Vandal, Aïssatou Fall, Julie Bruneau, Élise Roy, Suzanne Brissette, Chris Archibald, Nelson Arruda, Carole Morissette
Drug and Alcohol Dependence.2014; 142: 174. CrossRef
Heterogeneity and behavioral response in continuous time capture–recapture, with application to street cannabis use in Italy
Alessio Farcomeni, Daria Scacciatelli
The Annals of Applied Statistics.2013;[Epub] CrossRef

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