Prevalence of hepatitis C in drug users in Flanders: determinants and geographic differences

The prevalence of hepatitis C and related risk factors in drug users were compared in two geographic regions in Belgium, the city of Antwerp and the mixed urban–rural area of Limburg. All 310 participants were surveyed and screened for hepatitis B, hepatitis C and HIV. Prevalence rates of anti-HCV, anti-HBc and anti-HIV were 71, 62 and 4% in Antwerp and 46, 21 and 0% in Limburg respectively. Injecting drug use, duration of injecting drug use, work as a commercial sex-worker, originating from Turkey or Northern Africa, marginalization and anti-HBc positivity were identified as independent predictors for hepatitis C infection. In this study an important difference in HCV seroprevalence among drug users in a methadone maintenance programme across two geographic regions in Belgium was demonstrated. This was explained not only by variations in drug-related risk behaviour, but also by differences in sexual risk behaviour and socio-economic status.

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Factors Correlating to the Development of Hepatitis C Virus Infection among Drug Users—Findings from a Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16132345 ◽

2019 ◽

Vol 16 (13) ◽

pp. 2345 ◽

Cited By ~ 4

Author(s):

Biao Zhou ◽

Gao Feng Cai ◽

Hua Kun Lv ◽

Shuang Fei Xu ◽

Zheng Ting Wang ◽

...

Keyword(s):

Sexual Behavior ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Use ◽

Drug Users ◽

Methadone Maintenance ◽

Meta Analysis ◽

Injecting Drug Use ◽

Hcv Infection ◽

Increased Risk

Hepatitis C remains a significant public health threat. However, the main routes of transmission have changed since the early 1990s. Currently, drug use is the main source of hepatitis C virus (HCV) infection, and some measures have been successively implemented and additional studies have been published. However, the factors correlating with HCV infection failed to clearly define. Our study pooled the odds ratios (ORs) with 95% confidence intervals (CIs) and analyzed sensitivity by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Publication bias was determined by Egger’s test. In our meta-analysis, HCV-infected and non-HCV-infected patients from 49 studies were analyzed. The pooled ORs with 95% CIs for study factors were as follows: Injecting drug use 10.11 (8.54, 11.97); sharing needles and syringes 2.24 (1.78, 2.83); duration of drug use >5 years 2.39 (1.54, 3.71); unemployment 1.50 (1.22, 1.85); commercial sexual behavior 1.00 (0.73, 1.38); married or cohabiting with a regular partner 0.88 (0.79, 0.98), and sexual behavior without a condom 1.72 (1.07, 2.78). This study found that drug users with histories of injecting drug use, sharing needles and syringes, drug use duration of >5 years, and unemployment, were at increased risk of HCV infection. Our findings indicate that sterile needles and syringes should be made available to ensure safe injection. In view of that, methadone maintenance treatment can reduce or put an end to risky drug-use behaviors, and should be scaled up further, thereby reducing HCV infection.

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