Factors influencing a low rate of hepatitis C viral RNA clearance in heroin users from Southern China

Table 1 Characteristics of consecutively HCV ELISA positive heroin users from Guangxi Zhuang Autonomous Region, China

	Number (%)
	HCV RNA
	(+)	(-)	Total
	317 (91.35)	30 (8.65)	347
Factor
Location
Binyang	200	20	220
Pingxiang	117	10	127
Mean age (yr)
Mean ± SD	27.5 ± 5.7	25.4 ± 4.52	27.4 ± 5.6
Range	(19-50)	(19-37)	(19-50)
Gender
Male	307 (96.85)	27 (90.00)	334 (96.25)
Female	10 (3.15)	3 (10.00)	13 (3.75)
Ethnicity
Han	212 (66.88)	20 (66.67)	232 (66.86)
Zhuang	94 (29.65)	7 (23.3)	101 (29.11)
Other	11 (3.47)	3 (10.0)	14 (4.03)
Marital status
Single	215 (67.82)	21 (70.00)	236 (68.01)
Married	102 (32.18)	9 (30.00)	111 (31.99)
HIV Ab status
Positive	87 (27.44)	3 (10.00)	90 (25.94)
HBsAg status
Positive	32 (10.09)	14 (46.67)	46 (13.26)
HBsAb status
Positive	142 (44.79)	6 (20.00)	148 (42.65)
Injection drug use
Yes	294 (92.74)	29 (96.67)	323 (93.08)
Mean length of drug use
Months ± SD	63.7 ± 26.4	54.72 ± 28.2	62.9 ± 26.6
Range	(9.0-165.2)	(13.1-124.2)	(9.0-165.2)
Mean frequency of drug use
Per Month ± SD	73.9 ± 44.7	79.6 ± 34.6	74.4 ± 44.0
Range	(1.0-390.0)	(20.0-150.0)	(1.0-390.0)
Education level
College or above	1 (0.32)	0	1 (0.29)
High school	26 (8.25)	2 (6.9)	28 (8.14)
Middle school	151 (47.94)	12 (41.38)	163 (47.38)
Primary school	133 (42.22)	15 (51.72)	148 (43.02)
Illiterate	4 (1.27)	0	4 (1.16)
Unknown	2	1	3 (0.86)

SD: Standard deviation; HCV: Hepatitis C virus; HIVAb: HIV-1 antibody; HBsAg: Hepatitis B surface antigen; HBsAb: Antibody to hepatitis B surface antigen.

Table 2 Factors associated with hepatitis C viral clearance among 347 consecutively HCV antibody positive heroin users from Guangxi Zhuang Autonomous Region, China

	Number	Univariate	Final multivariate model
Factor	(% clearance)	Adjusted OR (95% CI)	Adjusted OR (95% CI)	P
Age (yr)
≤ 25	125 (13.6)	1.0	1.0
> 25	222 (5.9)	0.472 (0.221-1.006)	0.400 (0.176-0.909)	0.029
HIV Ab status
Negative	257 (10.5)	1.0	1.0
Positive	90 (3.3)	0.294 (0.087-0.993)	0.256 (0.071-0.924)	0.038
HBsAg status
Negative	301 (5.3)	1.0	1.0
Positive	46 (30.4)	7.793 (3.484-17.430)	8.436 (3.646-19.520)	< 0.0001
HBsAb status
Negative	199 (12.1)	1.0
Positive	148 (4.1)	0.308 (0.123-0.744)
Gender
Male	334 (8.1)	1.0
Female	13 (23.1)	3.411 (0.885-13.143)
Location
Binyang	220 (9.1)	1.0
Pingxiang	127 (7.9)	0.855 (0.387-1.888)
Ethnicity
Zhuang minority	115 (8.7)	1.0
Han	232 (8.6)	0.991 (0.448-2.192 )
Injection drug use
Yes	323 (9.0)	1.0
No	24 (4.2)	0.441 (0.057-3.384)
Length of drug use
< 5 yr	176 (10.8)	1.0
≥ 5 yr	171 (6.4)	0.568 (0.262-1.233)
Frequency of drug use
< 75 times per month	217 (7.4)	1.0
≥ 75 times per month	130 (10.8)	1.516 (0.714-3.219)

OR: Odds ratio; CI: Confidence Interval; HCV: Hepatitis C virus; HIVAb: HIV-1 antibody; HBsAg: Hepatitis B surface antigen; HBsAb: Antibody to hepatitis B surface antigen.

Table 3 HCV RNA clearance rates among previously published cohort studies

			HCV RNA
Principal investigator	Cohort	Number tested	Clearance rate (%)	Percent HIV Ab+	Percent HBsAg+
This study	Chinese IDU	347	8.71	25.9%	13.3%
Thomas[3]	African
	American IDU	729	9.3
	Non-African
	American IDU	44	36.0
	Overall	773	10.91	45.7%	3.5%
Alric[5]	Caucasian
	French	123	251	ND	ND
Minton[6]	Caucasian
	English	172	20.31	ND	ND
Yee[7]	English
	Hemophiliacs	200	141	40.3%	ND
Alter[8]	American blood
	Donors	248	142	ND	ND
	(42% IDU)
Kenny-Walsh[9]	Irish women	704	44.62	ND	ND
Alter[10]	Non-Hispanic
	African
	American	196	14.0
	Non-Hispanic
	Caucasian	119	32.0
	Hispanic
	Americans	132	26.0
	NHANES
	Overall	447	26.12	ND	ND
Sagnelli[11]	Italian liver
	Patients	336	21.73	ND	28%

¹HCV RNA by Roche AMPLICOR HCV Qualitative Assay-Sensitivity > 50 IU/mL;

²HCV RNA by In-house RT-PCR- Sensitivity Unknown;

³HCV RNA by HEPA-Check C - Sensitivity Unknown; HCV: Hepatitis C virus; IDU: Injection drug user; HIV: Human immunodeficiency virus 1; HBsAg: HBV surface antigen; ND: Not determined.