Epidemiological Study Of HCV Infection And Molecular Subtypes In Drug Addicts Monitored At Sentinel Sites In Inner Mongolia Autonomous Region

Objective:Through the analysis of the survey and data of the 2022 national AIDS drug use monitoring sentinel population in Inner Mongolia Autonomous Region,the characteristics of high-risk behaviors,as well as the status of hepatitis C virus infection,related risk factors and genotype distribution characteristics of this population were mastered,which provided a reference for the development of more accurate prevention and control measures and more effective antiviral treatment for hepatitis C virus infection in drug addicts in the autonomous region.Methods:Using the cross-sectional survey method,during the sentinel monitoring period from April to June 2022,continuous sampling of new drug users entering the supervised setting was carried out in sequential order.One-on-one face-to-face questionnaires were conducted with selected drug users in accordance with the questionnaire in the National AIDS Sentinel Monitoring Implementation Programme to collect general demographic information,information on high-risk behaviours and access to behavioural intervention services.After the questionnaire survey,the plasma samples of HCV antibody positive patients of drug addicts were collected from each league city and sent to the AIDS Confirmation Center Laboratory of the Inner Mongolia Autonomous Region Comprehensive Disease Control and Prevention Center for laboratory testing.Plasma samples of HCV antibody positive patients were quantified by RT-PCR fluorescent probe method.HCV genotype detection was performed by PCR-reverse point hybridization.SPSS software was used to perform statistical analysis such asX~2-test and logistic regression.Results:1.A total of 1659 drug addicts were monitored,with an average age of(43.67±9.52)years.Among them,the proportions of males,local household registration,junior high school education or below,Han nationality and married or cohabitants were 98.01%,85.65%,73.54%,89.33%and 46.05%respectively.The proportions of traditional drugs,new drugs and mixed drugs were 45.87%,48.88%and 5.24%respectively.Only 624 people used heroin and 445 people used only methamphetamine.2.Among drug users,there is a proportion of high-risk behaviors(injecting drug use,needle sharing and unsafe sex).There was a significant difference in the proportion of high-risk behaviors among different types of drug users(P<0.05).3.The positive rate of HCV antibody was 18.44%,and the positive rate of HCV RNA was 13.62%.The positive rates of HCV RNA in Baotou,Bayannur,Hohhot,Ordos and Wuhai were 8.50%,18.58%,20.75%,2.25%and 48.00%,respectively.There was a statistically significant difference in HCV infection rates between different cities(P<0.001).Age,household registration,injecting drug use and needle sharing are associated factors for HCV infection.4.Five genotypes were detected:HCV 1b,3a,3b,2a,and 6a,with 66,62,54,15,and 10 cases,respectively.The distribution of genotypes varies by age and ethnicity.The main genotypes of HCV in Han drug addicts were 1b,3a and 3b;The main genotype of HCV in ethnic minorities was 3a,and the proportion was significantly higher than that of Han(P<0.05).5.There were significant differences in HCV genotype composition between different cities(P<0.05).Wuhai is dominated by genotypes 3a and 3b,and the other four league cities are dominated by genotypes 1 or 1 and 3.All genotypes were mainly detected with medium and high viral loads,and the viral load of HCV type 3a had very high values and the highest average viral load.Conclusion:1.The sentinel monitoring drug users in the Inner Mongolia Autonomous Region are mainly males,local household registration,Han nationality,and those with junior high school education or below,and most of them are married/cohabiting.The highest number of people use new drugs,followed by traditional drugs;The most used drug type is heroin,followed by methamphetamine.High-risk behaviours such as injecting drug use,needle sharing and unsafe sex among drug users persist.2.The rate of HCV infection is higher in drug users;The HCV infection rate in Wuhai City is high.≥30 years old,local household registration,injecting drug users and needle sharing drug users are at higher risk of HCV infection.3.The distribution of HCV genotypes was diverse,mainly type 1b,followed by type 3a and 3b,and types 2a and 6a were also visible.The distribution of genotypes varies by age and ethnicity.4.There were significant differences in HCV genotype composition between different league cities;The viral load of HCV in all genotypes was high,and special attention should be paid to the diagnosis and treatment of genotype 3a.