Journal of Isfahan Medical School
Year:2011 | Volume:28 | Issue:SPECIAL ISSUE ON HEPATITIS C|Papers Count:8

Background: Hepatitis C, as a major public health problem, has serious complications and intravenous drug users are the most high risk group for it. This study was performed to determine hepatitis C seroepidemiolgy and related risk factors among intravenous drug users in Isfahan province.Methods: In this cross-sectional study, intravenous drug users (IVDUs) in central prison, Assadabad camp and Drop in Centers in Isfahan province were selected using census sampling method. After completion validated questionaire including demographic and risk factors by interiew, a 5 cc blood sample was obtained and HCV-Ab was detected using ELISA method.Finding: Among 1485 intravenous drug users (1457 male) with mean age of 32±7 years, 644 (43.4%) were HCV-Ab positive. Not being married, tatooing, needle share, prison history, history of going to dentist and duration of intravenous drug abuse were indepenedent risk factors for hepatitis C. Also, men with men sex, sex with intravenous drug users and unprotected sex (without condom) had significant relationship with hepatitis C. Among HCV risk factors, needle share and prison history had hightest relative and attributable risks. Using ROC curve, the cut off point for duration of intravenous drug abuse was estiamted as three months.Conclusion: The main results of this study indicated high prevalence rate of hepatitis C and the major role of needle share and prison history among intravenous drug users population in Isfahan province that needs to pay attention by governments.

Background: Injection drug use plays the most important role in transmission of hepatitis C. In Iran, surveys have been conducted on various high risk groups but this is the first announcement based study for anti-HCV prevalence among cases with history of intravenous drug using (IVDU) in the country.Methods: The announcement-based detection and follow-up of patients with anti-HCV positive project in volunteers with history of intravenous drug using was conducted in Isfahan province. At the first step, six focus groups were conducted and 2 pilot studies were carried out in two cities to design the main study. Comprehensive community announcement was done in all of public places and for physicians. The volunteers were invited to Isfahan reference laboratories and the serum samples were sent to Infectious Diseases Research Center Laboratory in standard conditions and HCV-Ab was tested by ELISA method.Finding: In this study, 1747 individuals that are estimated 50% of all expected intravenous drug users in the community were presented themselves. The most important reasons of success in recruiting volunteers in this study were the perfect propaganda, appropriate cooperation of lab staffs, continuous evaluation, and good cooperation in Isfahan province administrations. HCV-Ab was detected in 34% of them and the HCV-Ab positives were sent for further follow-up procedures including confirmatory test, education, and treatment.Conclusion: In spite of some limitations to select real cases, this study considered as a successful experience.Compared to the surveys in Iran on HCV prevalence in intravenous drug users, the results of this study which was based on volunteers by announcement seems to be noteworthy.

Background: Hepatitis C virus (HCV) is a major public health problem in the world which drug injection is a primary mode of transmission for it. So, this study was conducted to determine seroprevalence of HCV in intravenous drug abusers (IVDA) in Isfahan province Drop in centers (DIC).Methods: This qualitative/quantitave study used triangulation method in data collection and analysis.Five semi-structured focus groups with open-ended questions were disposed to evaluate and discuss on aspects of the study. Intravenous drug abusers in Isfahan province Drop in centers by non-probable purposive sampling method entered into the study voluntarily and blood sample was obtained from them. Serum samples were tested for HCV-Ab using ELISA method.Finding: There were seven govermental Drop in centers including 4 related to Isfahan University of Medical Sciences and 3 related to welfare organization which contained 1581 intravenous drug abusers members. From them, 539 patients (34%) enterd into the study from which, 250 (47.1%) patients were positive for HCV-Ab without significant differences between men and women. The main impressive factors for the project were wage for blood obtaning, occupational insurance, problems in interview and sampling, and time restriction.Conclusion: This was a good experience for other investigators and health directors’ strategies to design simillar studies or harm reduction.

Background: Frequent transfusion of blood and blood products to patients with thalassemia major and hemophilia and under hemodialysis patients may cause infections such as hepatitis infection in them.This study aimed to determine the prevalence of hepatitis C and associated risk factors in these patients in Isfahan, the second big province in Iran.Methods: In a descriptive study, all the patients with hemophilia and thalassemia and under hemodialysis in Isfahan province were enrolled. A questionnaire, including demographic and risk factors of hepatitis C was completed through a structured interview with closed questions by a trained interviewer for each patient and HCV-Ab test results were extracted from patient records.Finding: In this study, 60of 570 patients with thalassemia major (10.5%), 232 of 350 patients with hemophilia A and B (66%) and 17 of 800 under hemodialysis patients (2.1%) were positive for hepatitis C. Based on Multivariate Logistic Regression model, no independent risk factor was found.Conclusion: Prevalence of hepatitis C in patients with recurrent blood transfusion in Isfahan is high.Since no independent risk factor for hepatitis C disease was found in these three groups, it can be concluded that multitransfusion is the only predictor for hepatitis C.

Background: Hepatitis C is a major worldwide problem with remarkable medical burden which is emerging mostly due to intravenuos drug abuse. The prevalence of hepatitis C infection is higher among prison inmates because of the high proportion of injecting drug users. So, the aim of this study was to determine the seroprevalnce of hepatitis C infection among prisoners with history of intravenous drug abuse in Isfahan province-Iran.Methods: In this cross-sectional study, active and inactvie intravenous drug abusers were enrolled into study volluntarily with ethical considerations. Participants were interviwed using a structured questionnaire and a blood sample was collected for detection HCV antibody using ELISA method.Finding: From 6000 prison inmates in Isfahan central prison and Assadabad Camp, approximatly 20 percent (1200 ones) had history of intravenous drug abuse from which, 951 ones (80%) were intered in this study. The prevalenc of HCV infection was 42 percent and the main factores earned from this project experience were: problem in giving samples, problem in prison interance, separate interview and sample collecting, and desirable participants’ cooperation.Conclusion: According to success in obtaning nearly 80% of prison inmates with history of drug abuse, this is a good experience for other investigators and health directors to design simillar studies or executive protocols.

Background: Intravenous drug users (IVDUs) are the most at risk group for viral hepatitis C and injection drug is responsible to more than 60% of HCV infected new cases worldwide. Hepatitis C screening in centers for methadone maintenance treatment (MMT) has several benefits in harm reduction stategies.Methods: In an action research study, after coordinating centers for methadone maintenance treatment, questiononaires including demographic and risk factors of HCV were sent to 80 active centes in Isfahan province to complete and add their result for HCV-Ab test.Finding: Only seven centers with 1055 members, sent their completed questionaires to administrators, but most of documents were without any HCV-Ab test results. Overall, 74 (7.0%) participants were positive for hepatitis C.Conclusion: The results of this study indicated serious problem in execution which was due to lack of cooperration of the centers’ mannagers, stuffs, and members. Hence, it is recommended to do active intervention and consider a reward for future investigators.

Background: Incarcerated youths have a higher prevalence of behaviors that might put them at more risk for hepatitis C than the general public. This study was performed to determine prevalence of hepatitis C in inmates of a correctional center in Isfahan, Iran.Methods: In a cross-sectional study, during one year, 160 under 18-year old incarecerated individuals using nonprobable sampling method were enrolled in the study. Risky behaviours were obtained by a validated questionaire and blood sample for hepatitis C detection. The experiences of administration were gathered and analysed by content analysis.Finding: All of the elligible participants were voluntarily enrolled in the study. This population consisted of the 147 boys and 13 girls. Seven cases of hepatitis C were diagnosed that makes HCV prevalence 4.4%.Conclusion: This was a successful experience due to the excellent caoperation between suffs of correctionl centers and the investigators. However, the high HCV prevalence obserrved in this study leads us to prepare and education programmes to decrease HCV spread and risky behavours in this population.

Background: Intravenous drug abuse is a worldwide problem with side effects as hepatitis C. Hepattis C infection, which has severe complications like cirrosis and hepatocellular carcinoma, is a tragedy for communities, so, screening it in intravenous drug abusers has a lot of benefits. According to lack of a community based study in Isfahan, Iran, this pilot study carried out in Golpayegan city in Isfahan Province.Methods: In a cross sectional pilot study, hepatitis C in intravenous drug abusers population in Golpaygan, Isfahan was screened by community annaouncement method. After co-opperation with managers, administrative stafs and all of the stakeholders, the study population was invited to refference laboratories where blood samples were chpsen and tested for anti-HCV-Ab. The results were sent privately and patients were invited to participate in educational and treatment procedure.Finding: From 136 persons participated voluntarily, 28 were anti-HCV-Ab positive (19.8%).Conclusion: In this pilot study, 85% of estimated population was participated that is excellent experience for larger studies.