Prevalence and predictors of HCV among a cohort of opioid treatment patients in Dar es Salaam,Tanzania |
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| Affiliation: | 1. RTI-International, San Francisco, CA , United States;2. University of California San Francisco, San Francisco, CA, United States;3. University of Washington, Seattle, WA, United States;4. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;5. Yale University, New Haven, CT, United States;1. Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong, Hong Kong SAR, China;2. Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China;3. Institute of Infectious Disease, 302 Hospital, Beijing, China;4. Service d''Hépatologie, Hôpital Pitié-Salpêtrière, Paris, France;5. State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China;6. Hong Kong Molecular Pathology Diagnostic Centre, Hong Kong SAR, China;7. Center for AIDS Research, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA;8. Theoretical Biology and Biophysics, MS-K710, Los Alamos National Laboratory, Los Alamos, NM, USA;9. Department of Mathematics, North Carolina State University, Raleigh, NC, USA;1. Disease Elimination Program, Burnet Institute, Melbourne 3004, VIC, Australia;2. Department of Infectious Diseases, The Alfred Hospital, Melbourne, VIC, Australia;3. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia;4. Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia;1. Research Group of HIV Molecular Epidemiology and Virology, Center for Emerging Infectious Disease, The State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, PR China;2. Department of Intractable Diseases, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan;1. Institute of Plant Science and Resources, Okayama University, 2-20-1 Chuo, Kurashiki, Okayama 710-0046, Japan;2. Department of Biochemistry, Faculty of Science, Burapha University, Bangsaen, Chonburi 20131, Thailand;3. Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200, Nairobi, Kenya;4. Faculty of Engineering, Shizuoka University, 3-5-1 Johoku, Kita-ku, Hamamatsu 432-8561, Japan;5. Egitim Fakultesi, Mugla Sitki Kocman University, 48170 Kotekli, Mugla, Turkey |
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| Abstract: | BackgroundThe government of Tanzania launched an opioid treatment program (OTP), using methadone, in Dar es Salaam in February of 2011. Hepatitis C virus (HCV) is a leading cause of morbidity and mortality globally, especially among people who inject drugs (PWID). We conducted a cross-sectional study among PWID engaged in OTP in Dar es Salaam to describe the prevalence and predictors of HCV antibody serostatus.MethodsRoutine programmatic data on patients enrolled in Muhimbili National Hospital’s OTP clinic from February 2011 to January 2013 were utilized. Multivariable Poisson regression was used to examine factors associated with HCV antibody serostatus.ResultsA total of 630 PWID enrolled into the OTP clinic during the study period, seven percent of which were women. The overall seroprevalence of HCV antibody was 57% (95% Confidence interval: 53–61%). In adjusted analysis, methadone patients who used heroin for 5–10 years (adjusted prevalence ratio; aPR = 1.41; 95% CI: 1.10–1.81) and >10 years (aPR = 1.48; 95% CI: 1.17–1.88) were more likely to be HCV antibody positive, compared to patients who used heroin for <5 years. Patients who reported sharing needles or other equipment at their last injection (aPR = 1.20; 95% CI: 1.01–1.41; p = 0.022), being arrested (aPR = 1.20; 95% CI: 1.04–1.40; p = 0.012) and who were HIV-positive (aPR = 1.84; 95% CI: 1.56–2.16; p < 0.001) were also more likely to be HCV antibody positive than their counterparts.ConclusionOur observed HCV antibody prevalence among PWID engaged in OTP is higher than previously reported estimates in Dar es Salaam. Predictors of HCV antibody serostatus in this sample were similar to those found among PWID in many other settings. Integrating HCV care and treatment into OTP clinics should be considered, leveraging lessons learned from the integration of HIV services into OTP. Global efforts to develop HCV care and treatment programs in low and middle-income countries are critical, especially among PWID who have a high burden of HCV. |
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| Keywords: | Hepatitis C People who inject drugs Methadone Opioid treatment Tanzania Sub Saharan Africa |
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