Prevalence of Hepatitis C, B and Human Immunodeficiency Virus among Drug Users and Chronic Alcoholic Patients in Korea

Kim, Hyo Suck; Choo, Dong Ho

Abstract

OBJECTIVES
After introduction of anti-HCV assay as screening test of blood donors, the proportion of trasfusion-associated hepatitis C declined, but the proportion of hepatitis C patients with a history of parenteral drug use increased, HCV, HRV, and H1V share similiar modes of transmission and prevalent among intravenous drug users in America. Recently the number of drug users in Korea has been increasing. Therefore we investigated the prevalence of HCV, HBV, and HIV among drug users in our country. In addition several recent reports showed that anti-HCV were freguently positive in the chronic alcoholics and HCV might play a role in the development of severe liver disease in these patients. We assessed the prevalence of anti-HCV and its re1ationship to the severity of liver disease in chronic alcoholic patients.
METHODS
The prevalence of anti-HCV, HHsAg, and anti-HIV among 185 drug users who were admitted at Taegu Medical Center from January 1994 to December 1995 has been studied using ELISA and the history of drug use including sort, route, and duration investigated. In addition, We studied the prevalence of anti-HCV and its relationship to the severity of liver disease in 73 chronic alcoholics.
RESULTS
1) Among 176 methamphetamine intravenous users, the prevalence of anti-HCV was 80%, that of HBsAg was 4%, and there was none with anti-HIV positive in 131 cases tested. Of the 9 marihuana smokers, all of them were negative in anti-HCV or anti-HIV, and only 1 caese(11%) was HBsAg positive. 2) Longer duration of intravenous drug use was significantly associated with anti-HCV seropositivity, Elevated ALT level was found in 80 cases(57%) of the anti-HCV seropositive 140 cases and their mean was 971U/L. 3) The group with higher optical density of anti-HCV showed inclination of elevated ALT level; however there was no significant correlation between anti-HCV optical density and ALT level. 4) The prevalence of anti-HCV was 11% in 73 chronic alcoholic patients, and that of HBsAg was 4%. The seropositivity of anti-HCV correlated with the severity of liver disease: none in patients with no liver problem or fatty liver, 12.5% in patients with chronic liver disease, 1996 in patients with cirrhosis classified by clinical, biochemical, and ultrasonographic findings, However the presence of anti-HCV was not associated with impaired liver function tests in chronic liver disease and cirrhosis groups.
CONCLUSION
The prevalence of anti-HCV among intravenous drug users in Korea was 80%, similiar to that in America, By contrast the prevalence of HBsAg was only 4%, lower than that of general population. And there was no HIV-infected cases among intravenous drug users in our study. The seropositivity of anti-HCV among chronic alcoholic patients was 11%. And increased prevalence of anti-HCV in alcoholic patients with severe liver disease might suggest that hepatitis C virus is involved in liver damage in these patients.