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HEPATITIS C INFECTION AMONG DRUG USERS IN NORTHERN THAILAND

Illicit drug users are commonly infected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV). We evaluated the prevalence, incidence, and risk behaviors associated with HCV infection in 1,859 drug users in northern Thailand. The HCV prevalence was 27.3%: 86.0% among drug injectors (IDUs) and 5.3% among those who did not inject. Sexual behavior was not significantly associated with HCV among IDUs or drug users who used but didn’t inject illicit drugs; only injection behaviors were independently associated with HCV in multivariate analysis. Among men, a history and increasing frequency of injecting drugs, older age, and a history of incarceration were associated with HCV infection. Among 514 opiate users who were HCV and HIV seronegative at baseline, 41 incident HCV infections and 6 HIV infections occurred on follow-up; the HCV incidence was 5.43/100 person-years; it was 44.3/100 person-years in IDUs and 1.9/100 person-years in non-injectors. HCV and HIV among drug users in Thailand are common and primarily associated with injection behavior.

Received January 20, 2005. Accepted for publication February 8, 2006.

Financial support: This research was supported in part by Grants DA-11333 and U01 DA-13032 from the National Institute of Drug Abuse, National Institutes of Health. None of the authors has a conflict of interest.

^* Address correspondence to Kenrad E. Nelson, Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205. E-mail: kenelson{at}jhsph.edu

Authors’ addresses: Jaroon Juttiwutikarn, Northern Drug Dependence Treatment Center, Mae Rim, Thailand. Satawat Thongsawat, Vinai Suriyanon, Niwat Maneekarn, Namtip Srirak, Tassanai Vongchak, and Surinda Kawichai, Faculty of Medicine and Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. David D. Celentano, David L. Thomas, Teerada Sripaipan, Dale Netski, Ashwin Ananthakrishnan, and Kenrad E. Nelson, Johns Hopkins Medical Institutions, Baltimore, MD, E-mails: kenelson{at}jhsph.edu. Myatt Htoo Razak, Medical officer (HIV/AIDS), World Health Organization, Thailand, Permanent Secretary Building 3, 4th Flr., Ministry of Public Health, Bangkok, Thailand.