[Current Hepatitis C Status among People Who Use Drugs in the Republic of Korea]

While the number of persons who use drugs (PWUD) in the Republic of Korea (ROK) is increasing, studies on hepatitis C virus (HCV) infection among this population are scarce. We investigated HCV prevalence and treatment rates among PWUD.

Between August 2022 and May 2024, 342 PWUD from four hospitals were prospectively enrolled in this study. These four hospitals cover 95% of PWUD care in ROK. All participants underwent blood testing and completed questionnaires. Participants whose HCV antibody (anti-HCV) test result was positive underwent a reflex test for HCV RNA. Participants were divided into persons who inject drugs (PWID) and non-PWID groups based on their use of drugs by injection.

PWID and non-PWID groups comprised 92.1% and 7.9% of total patients, respectively (median age, 46 years; 76.0% male). In the PWID group, respective anti-HCV and HCV RNA prevalences were 32.4% and 11.1%. In the non-PWID group, respective anti-HCV and HCV RNA prevalences were 18.5% and 3.7%. HCV RNA positivity independently associated with sharing of syringes (odds ratio [OR] 3.300, 95% confidence interval [CI] 1.236-8.850) and piercings performed before 1992 (OR 8.336, 95% CI 1.654-42.008, p=0.010). Among anti-HCV-positive patients, HCV infection awareness was 74.8%, and their treatment rate was 53.3%. The only independent factor associated with treatment history was knowledge on the HCV infection (OR 5.076, 95% CI 1.328-12.231, p=0.018). In the PWID and non-PWID groups with anti-HCV positivity, 34.3% and 20.0%, respectively, remained HCV RNA-positive due to untreated hepatitis C.

Anti-HCV seropositivity and HCV RNA positivity were high in both PWID and non-PWID groups compared to general population, and these patients' access to care was insufficient. It is thus necessary to develop strategies to increase HCV treatment access for PWUD.