Hepatitis C seroprevalence among intravenous drug users in Tehran

BACKGROUND: Hepatitis C (HCV) is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers (IDU), especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositiv- ity among IDU prisoners and compared it with those of non-prisoners. METHODS: A cross-sectional study was conducted on consenting IDUs inhabiting two prisons and attending three reha- bilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5 ml blood was drawn. The sam- ples were kept at 2-8° C until the sera were separated and stored at -70° C . HCVAb (ELISA) was checked by a single technician. Chi-square, Fisher's exact test and multivariate analysis were used where appropriate. RESULTS: Five-hundred and eighteen subjects were enrolled. About 74.5% were prisoners and 89.6% were male. Over- all, 59.5% were positive for HCVAb (93.2% males and 6.8% females, P < 0.02). HCV seropositivity was higher among prisoners compared to non-prisoners (78.3% vs. 30.6%, respectively, P < 0.001). Also, it was higher in IUD older than 45 year-old compared to those younger than 30 year-old (77.8% vs. 54.2%, respectively, P = 0.002). Multivariate analy- sis showed significant association of HCV seropositivity with imprisonment (OR: 9.32, 95% CI: 5.60-15.51), sharing syringes (OR: 2.00, 95% CI: 1.26-3.17) and duration of intravenous drug use (OR: 0.86, 95% CI: 0.80-0.92). CONCLUSIONS: HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor for HCV and the infected IDUs going back to the society could be an important source of HCV. Taking effective strategies (educa- tion of high risk groups, provision of sterile syringes, identification and treatment of infected IDUs) to reduce the risk of this public health problem is needed urgently.