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Development and Validation of a Risk Prediction Tool to Identify People at Greater Risk of Having Hepatitis C among Drug Users

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  • Gang Huang

    (Medical School of Ningbo University, Ningbo University, Ningbo 315211, China
    These authors contributed equally to this work.)

  • Wei Cheng

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
    These authors contributed equally to this work.)

  • Yun Xu

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

  • Jiezhe Yang

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

  • Jun Jiang

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

  • Xiaohong Pan

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

  • Xin Zhou

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

  • Jianmin Jiang

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
    Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou 310051, China)

  • Chengliang Chai

    (Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China)

Abstract

Background: People who use drugs (PWUD) are among those with the highest risk for hepatitis C virus (HCV) infection. Highly effective direct-acting antiviral agents offer an opportunity to eliminate HCV. A simple tool for the prediction of HCV infection risk in PWUD is urgently needed. This study aimed to develop and validate a risk prediction tool to identify people at greater risk of having hepatitis C among PWUD that is applicable in resource-limited settings. Methods: We extracted data from national HIV/AIDS sentinel surveillance in PWUD (Zhejiang Province, 2016–2021) and developed and validated a risk score to improve HCV testing in PWUD. This risk score consists of seven risk factors identified using multivariable logistic regression modeling (2016–2020, exploratory group). We validated this score using surveillance data for 2021 (validation group). The accuracy of the model was determined using C-statistics. Results: We identified seven risk factors, including sex, age, marital status, educational attainment, and the use of heroin, morphine, and methamphetamine. In the exploratory group, the positive rates of detecting the HCV antibody in the low-risk (0–9 points), intermediate-risk (10–16 points), and high-risk (≥17 points) groups were 6.72%, 17.24%, and 38.02%, respectively ( P trend < 0.001). In the validation group, the positive rates in the low-, medium-, and high-risk groups were 4.46%, 12.23%, and 38.99%, respectively ( P trend < 0.001). Conclusions: We developed and validated a drug-specific risk prediction tool for identifying PWUD at increased risk of HCV infection. This tool can complement and integrate the screening strategy for the purpose of early diagnosis and treatment.

Suggested Citation

  • Gang Huang & Wei Cheng & Yun Xu & Jiezhe Yang & Jun Jiang & Xiaohong Pan & Xin Zhou & Jianmin Jiang & Chengliang Chai, 2022. "Development and Validation of a Risk Prediction Tool to Identify People at Greater Risk of Having Hepatitis C among Drug Users," IJERPH, MDPI, vol. 19(23), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15677-:d:983891
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    References listed on IDEAS

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    1. Diaz, T. & Des Jarlais, D.C. & Vlahov, D. & Perlis, T.E. & Edwards, V. & Friedman, S.R. & Rockwell, R. & Hoover, D. & Williams, I.T. & Monterroso, E.R., 2001. "Factors associated with prevalent hepatitis C: Differences among young adult injection drug users in lower and upper Manhattan, New York City," American Journal of Public Health, American Public Health Association, vol. 91(1), pages 23-30.
    2. Browne, D.C. & Clubb, P.A. & Wang, Y. & Wagner, F., 2009. "Drug use and high-risk sexual behaviors among African American men who have sex with men and men who have sex with women," American Journal of Public Health, American Public Health Association, vol. 99(6), pages 1062-1066.
    3. Zibbell, J.E. & Asher, A.K. & Patel, R.C. & Kupronis, B. & Iqbal, K. & Ward, J.W. & Holtzman, D., 2018. "Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014," American Journal of Public Health, American Public Health Association, vol. 108(2), pages 175-181.
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