Hepatitis C seroconversion in methadone maintenance treatment programs in Wuhan, China

Addiction. 2015 May;110(5):796-802. doi: 10.1111/add.12836. Epub 2015 Jan 22.


Background and aims: To decrease infectious disease transmission, China is expanding methadone maintenance treatment (MMT). This study evaluated the prevalence of hepatitis C virus (HCV) infection at MMT entry, seroconversion rates after admission and potential risk factors for HCV seroconversion during MMT in Wuhan, China.

Design: Cross-sectional survey of all patients entering MMT and prospective follow-up of patients HCV seronegative at admission.

Setting: All MMT clinics in Wuhan, China.

Participants: A total of 12 755 opiate-dependent individuals entering MMT between May 2006 and June 2011; 1200 participants HCV seronegative at admission were followed.

Measurements: Serological tests for HCV and self-report data on risk behaviors at MMT admission; urine toxicology results and repeated assessments of serological status and risk behaviors during treatment on patients HCV seronegative at admission.

Findings: HCV seroprevalence at admission was 72.1% [95% confidence interval (CI) = 71.3-72.9%] and 555/1200 (46.3%, 95% CI = 43.5-49.1%) patients seroconverted to HCV during MMT. The mean time to HCV seroconversion was 3 (95% CI = 2.84-3.07) years with a cumulative seroconversion rate of 34.5 (95% CI = 31.5-36.9) per 100 person-years. Significant predictors of HCV conversion included injection drug use in the past 30 days [relative hazard (RH) 2.0, 95% CI: 1.6 - 2.4, P=0.002] and the rate of opiate-positive urine tests during MMT (RH 2.0, 95% CI = 1.3-3.1, P<0.001).

Conclusions: Methadone maintenance treatment patients in Wuhan, China show a high prevalence of hepatitis C virus at admission (72.1%) and a high rate of seroconversion during treatment (46.3%). Seroconversion is associated with continuing injection drug use.

Keywords: Behavioral risks; hepatitis C virus; injection drug use; methadone maintenance treatment; opiate dependence; seroconversion.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hepatitis C / blood
  • Hepatitis C / epidemiology*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Opiate Substitution Treatment*
  • Opioid-Related Disorders / blood
  • Opioid-Related Disorders / rehabilitation*
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Seroconversion*
  • Seroepidemiologic Studies
  • Substance Abuse, Intravenous / blood
  • Substance Abuse, Intravenous / rehabilitation*


  • Methadone