Prevalence of HCV infection and related risk factors in drug users in Wenzhou, Zhejiang, 2011–2020

  Objective  To understand the prevalence of hepatitis C and related risk factors in drug users under sentinel surveillance in Wenzhou during 2011–2020 and provide evidence for the prevention and control of hepatitis C in this population.

  Methods  A consecutive cross-sectional survey with standard questionnaire was conducted in about 400 drug users randomly selected in compulsory detoxification settings for the annual sentinel surveillance between April and July during 2011–2020, and basic demographic information and blood samples were collected from them. Multivariate logistic regression model was used to analyze the related risk factors of HIV infection.

  Results  A total of 4052 drug users were included in the analysis, the prevalence rate of HCV infection was 41.91%. The average positive rate of HCV antibody was 54.10% during 2011–2013, and 36.65% during 2014–2020. However, the positive rate of HCV antibody increased from 30.00% in 2014 to 41.50% in 2020. Multivariate logistic regression analysis indicated HCV infection risk factors included age ≥30 years, living in Zhejiang, low education level, being traditional drug user or mixed drug user and injecting drug use. Among them, age ≥30 years, living in Zhejiang, being traditional drug user or mixed drug user and injecting drug use can explain the rise of HCV antibody positive rate from 2014 to 2020.

  Conclusion  In the past 10 years, the prevalence of HCV infection in drug users in Wenzhou remained at a high level, showing a significant decline firstly and then a gradual rise. It is speculated that the early decrease of HCV infection level might be related to the improvement of the diagnosis and treatment of Hepatitis C, but the recent increase of HCV infection level is caused by the changes in the characteristics of drug users and the types or modes of drug use.