Hepatitis C virus infection among people who inject drugs in Bangkok, Thailand, 2005-2010

Bangkok Tenofovir Study Group

Research output: Contribution to journalArticle

Abstract

Background: Approximately 1% of adults in Thailand are infected with hepatitis C virus (HCV). New direct-acting antiviral agents achieve sustained virologic responses in >95% of HCV-infected patients and are becoming available in countries around the world. To prepare for new HCV treatment options in Thailand, this study characterized HCV infections among people who inject drugs (PWID) in Bangkok. Methods: The Bangkok Tenofovir Study (BTS) was a pre-exposure prophylaxis trial conducted among PWID, 2005-2013. Blood specimens were randomly selected from PWID screened for the BTS, to test for anti-HCV antibody and HCV RNA. The HVR1 region was amplified by polymerase chain reaction, using multiplex primer sets with unique identifier sequences; amplification products were pooled in sets of 25; and consensus sequencing was performed to characterize individual HCV genotypes. Results: The median age of 3679 participants tested for anti-HCV antibody was 31 years, 3016 (82.0%) were male and 447 (12.2%) were HIV infected. The prevalence of anti-HCV antibody was 44.3%. The adjusted odds of testing positive for anti-HCV antibody were higher in men (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] 2.4-4.3), those aged 40 years or older (aOR 2.7, 95% CI 2.1-3.5), those who had more than a primary school education (aOR 1.7, 95% CI 1.4-2.1), and those who tested HIV positive (aOR 5.2, 95% CI 3.7-7.4). HCV RNA was detected in 644 (81.3%) of the 792 anti-HCV antibody-positive specimens, yielding an HCV RNA-positive prevalence of 36.0% (95% CI 33.8-38.2). Among a random sample of 249 of the 644 specimens, 218 could be characterized, and the most common HCV subtypes were 1a (30.3%), 1b (12.8%), 3a (35.8%), 3b (6.9%) and 6n (8.7%). Conclusion: The prevalence of anti-HCV antibody among PWID was 44.3% and more than one third (36.0%) were HCV RNA positive. Genotypes 1, 3 and 6 accounted for all typable infections. As the government of Thailand considers introduction of direct-acting antiviral medications for people with hepatitis C, it will be important to ensure that the medications target these subtypes.

Original languageEnglish (US)
Pages (from-to)50-55
Number of pages6
JournalWHO South-East Asia journal of public health
Volume8
Issue number1
DOIs
StatePublished - Apr 1 2019

Fingerprint

Virus Diseases
Thailand
Hepacivirus
Hepatitis C Antibodies
Pharmaceutical Preparations
Tenofovir
Confidence Intervals
Odds Ratio
RNA
Antiviral Agents
Genotype
HIV
Multiplex Polymerase Chain Reaction
Hepatitis C
Education

Keywords

  • direct-acting antivirals
  • hepatitis C
  • people who inject drugs
  • Thailand
  • viral hepatitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hepatitis C virus infection among people who inject drugs in Bangkok, Thailand, 2005-2010. / Bangkok Tenofovir Study Group.

In: WHO South-East Asia journal of public health, Vol. 8, No. 1, 01.04.2019, p. 50-55.

Research output: Contribution to journalArticle

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title = "Hepatitis C virus infection among people who inject drugs in Bangkok, Thailand, 2005-2010",
abstract = "Background: Approximately 1{\%} of adults in Thailand are infected with hepatitis C virus (HCV). New direct-acting antiviral agents achieve sustained virologic responses in >95{\%} of HCV-infected patients and are becoming available in countries around the world. To prepare for new HCV treatment options in Thailand, this study characterized HCV infections among people who inject drugs (PWID) in Bangkok. Methods: The Bangkok Tenofovir Study (BTS) was a pre-exposure prophylaxis trial conducted among PWID, 2005-2013. Blood specimens were randomly selected from PWID screened for the BTS, to test for anti-HCV antibody and HCV RNA. The HVR1 region was amplified by polymerase chain reaction, using multiplex primer sets with unique identifier sequences; amplification products were pooled in sets of 25; and consensus sequencing was performed to characterize individual HCV genotypes. Results: The median age of 3679 participants tested for anti-HCV antibody was 31 years, 3016 (82.0{\%}) were male and 447 (12.2{\%}) were HIV infected. The prevalence of anti-HCV antibody was 44.3{\%}. The adjusted odds of testing positive for anti-HCV antibody were higher in men (adjusted odds ratio [aOR] 3.2, 95{\%} confidence interval [CI] 2.4-4.3), those aged 40 years or older (aOR 2.7, 95{\%} CI 2.1-3.5), those who had more than a primary school education (aOR 1.7, 95{\%} CI 1.4-2.1), and those who tested HIV positive (aOR 5.2, 95{\%} CI 3.7-7.4). HCV RNA was detected in 644 (81.3{\%}) of the 792 anti-HCV antibody-positive specimens, yielding an HCV RNA-positive prevalence of 36.0{\%} (95{\%} CI 33.8-38.2). Among a random sample of 249 of the 644 specimens, 218 could be characterized, and the most common HCV subtypes were 1a (30.3{\%}), 1b (12.8{\%}), 3a (35.8{\%}), 3b (6.9{\%}) and 6n (8.7{\%}). Conclusion: The prevalence of anti-HCV antibody among PWID was 44.3{\%} and more than one third (36.0{\%}) were HCV RNA positive. Genotypes 1, 3 and 6 accounted for all typable infections. As the government of Thailand considers introduction of direct-acting antiviral medications for people with hepatitis C, it will be important to ensure that the medications target these subtypes.",
keywords = "direct-acting antivirals, hepatitis C, people who inject drugs, Thailand, viral hepatitis",
author = "{Bangkok Tenofovir Study Group} and Michael Martin and Suphak Vanichseni and Wanna Leelawiwat and Rapeepan Anekvorapong and Boonyos Raengsakulrach and Thitima Cherdtrakulkiat and Udomsak Sangkum and Mock, {Philip A.} and Manoj Leethochawalit and Sithisat Chiamwongpaet and McNicholl, {Janet M.} and Somyot Kittimunkong and Marcel Curlin and Kachit Choopanya",
year = "2019",
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T1 - Hepatitis C virus infection among people who inject drugs in Bangkok, Thailand, 2005-2010

AU - Bangkok Tenofovir Study Group

AU - Martin, Michael

AU - Vanichseni, Suphak

AU - Leelawiwat, Wanna

AU - Anekvorapong, Rapeepan

AU - Raengsakulrach, Boonyos

AU - Cherdtrakulkiat, Thitima

AU - Sangkum, Udomsak

AU - Mock, Philip A.

AU - Leethochawalit, Manoj

AU - Chiamwongpaet, Sithisat

AU - McNicholl, Janet M.

AU - Kittimunkong, Somyot

AU - Curlin, Marcel

AU - Choopanya, Kachit

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: Approximately 1% of adults in Thailand are infected with hepatitis C virus (HCV). New direct-acting antiviral agents achieve sustained virologic responses in >95% of HCV-infected patients and are becoming available in countries around the world. To prepare for new HCV treatment options in Thailand, this study characterized HCV infections among people who inject drugs (PWID) in Bangkok. Methods: The Bangkok Tenofovir Study (BTS) was a pre-exposure prophylaxis trial conducted among PWID, 2005-2013. Blood specimens were randomly selected from PWID screened for the BTS, to test for anti-HCV antibody and HCV RNA. The HVR1 region was amplified by polymerase chain reaction, using multiplex primer sets with unique identifier sequences; amplification products were pooled in sets of 25; and consensus sequencing was performed to characterize individual HCV genotypes. Results: The median age of 3679 participants tested for anti-HCV antibody was 31 years, 3016 (82.0%) were male and 447 (12.2%) were HIV infected. The prevalence of anti-HCV antibody was 44.3%. The adjusted odds of testing positive for anti-HCV antibody were higher in men (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] 2.4-4.3), those aged 40 years or older (aOR 2.7, 95% CI 2.1-3.5), those who had more than a primary school education (aOR 1.7, 95% CI 1.4-2.1), and those who tested HIV positive (aOR 5.2, 95% CI 3.7-7.4). HCV RNA was detected in 644 (81.3%) of the 792 anti-HCV antibody-positive specimens, yielding an HCV RNA-positive prevalence of 36.0% (95% CI 33.8-38.2). Among a random sample of 249 of the 644 specimens, 218 could be characterized, and the most common HCV subtypes were 1a (30.3%), 1b (12.8%), 3a (35.8%), 3b (6.9%) and 6n (8.7%). Conclusion: The prevalence of anti-HCV antibody among PWID was 44.3% and more than one third (36.0%) were HCV RNA positive. Genotypes 1, 3 and 6 accounted for all typable infections. As the government of Thailand considers introduction of direct-acting antiviral medications for people with hepatitis C, it will be important to ensure that the medications target these subtypes.

AB - Background: Approximately 1% of adults in Thailand are infected with hepatitis C virus (HCV). New direct-acting antiviral agents achieve sustained virologic responses in >95% of HCV-infected patients and are becoming available in countries around the world. To prepare for new HCV treatment options in Thailand, this study characterized HCV infections among people who inject drugs (PWID) in Bangkok. Methods: The Bangkok Tenofovir Study (BTS) was a pre-exposure prophylaxis trial conducted among PWID, 2005-2013. Blood specimens were randomly selected from PWID screened for the BTS, to test for anti-HCV antibody and HCV RNA. The HVR1 region was amplified by polymerase chain reaction, using multiplex primer sets with unique identifier sequences; amplification products were pooled in sets of 25; and consensus sequencing was performed to characterize individual HCV genotypes. Results: The median age of 3679 participants tested for anti-HCV antibody was 31 years, 3016 (82.0%) were male and 447 (12.2%) were HIV infected. The prevalence of anti-HCV antibody was 44.3%. The adjusted odds of testing positive for anti-HCV antibody were higher in men (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] 2.4-4.3), those aged 40 years or older (aOR 2.7, 95% CI 2.1-3.5), those who had more than a primary school education (aOR 1.7, 95% CI 1.4-2.1), and those who tested HIV positive (aOR 5.2, 95% CI 3.7-7.4). HCV RNA was detected in 644 (81.3%) of the 792 anti-HCV antibody-positive specimens, yielding an HCV RNA-positive prevalence of 36.0% (95% CI 33.8-38.2). Among a random sample of 249 of the 644 specimens, 218 could be characterized, and the most common HCV subtypes were 1a (30.3%), 1b (12.8%), 3a (35.8%), 3b (6.9%) and 6n (8.7%). Conclusion: The prevalence of anti-HCV antibody among PWID was 44.3% and more than one third (36.0%) were HCV RNA positive. Genotypes 1, 3 and 6 accounted for all typable infections. As the government of Thailand considers introduction of direct-acting antiviral medications for people with hepatitis C, it will be important to ensure that the medications target these subtypes.

KW - direct-acting antivirals

KW - hepatitis C

KW - people who inject drugs

KW - Thailand

KW - viral hepatitis

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DO - 10.4103/2224-3151.255350

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JO - WHO South-East Asia journal of public health

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