مجله دانشکده پزشکی اصفهان
پیاپی 124 (1389)

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.

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.

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.

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.

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.

In an action research study, after coordinating centers for MMT, 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.

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.

The results of this study indicated serious problem in execution which was due to lack of cooperration of the center's mannagers, stuffs and members. Hence, it is recommended to do active intervention and consider a reward for future investigators.

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.

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.

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%.

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.