Sociodemographic, clinical, and other serological profile of opioid-dependent intravenous drug users infected with hepatitis C virus: A cross-sectional study

Abstract

Introduction: As per the 2023 National Acquired Immunodeficiency Syndrome Control Programme report, there are 8.5 lakh intravenous drug users (IDUs) in India, although the figures have varied greatly from the year 2009 to 2023. The IDU size population in Punjab is about 2600 to 18,000 as per the year 2008 survey reports. In the 2008 survey, the majority of such patients belonged to the age group of 18 to 30 years and most of them were employed, and the mean duration of IDU was 3 to 7 years. The total number of patients receiving in-patient treatment during the past 6-month period was only 15 clients per month. IDUs with HCV infections are more likely to have hepatitis B and HIV infections. Aim and Objectives: 1. To study the sociodemographic factors of HCV-infected IDUs admitted in the psychiatry ward of Sri Guru Ram Das (SGRD) Medical College, Vallah, Amritsar. 2. To study the clinical features, psychiatric profile, hepatitis B surface antigen (HBsAg), and HIV status of HCV-infected IDUs. Methodology: This was a hospital-based, observational, cross-sectional study conducted in the Department of Psychiatry at SGRD Medical College, Vallah, Amritsar. The data were collected from the year 2019 to 2023 consisting of the sociodemographic profile, IDU status, HCV status, and psychiatric history of all the opioid-dependent patients admitted during this time. The HBsAg and HIV status of the same patients were also collected. Results: In our study, the mean age group was 25 ± 5 years. All were males (100%). The majority of the patients were educated up to higher secondary level. The majority of cases started using intravenous drugs out of curiosity (52.5%). Most of them were using heroin from 0 to 5 years (56.7%). Most of them had tried to quit substances 2 or more times in the form of deaddiction treatment (49%) and had relapsed due to craving. Most patients were still IDU positive or relapsed to be IDU positive again despite being HCV reactive (66.7%) because of craving (44.5%) and stress and comorbid psychiatric disorders (30%). Bipolar disorder (46.7%), schizophrenia (33.3%), and personality disorders (6.7%) were common psychiatric illnesses seen in the studied cases. Most of them had a positive family history for substance use (60%). Conclusion: The opioid-dependent and HCV-infected IDUs having psychiatric illness are likely to have coinfections such as hepatitis B and HIV. All such patients need to be comprehensively evaluated for such coinfections.

Keywords

• hepatitis b surface antigen
• hepatitis c virus status
• hiv infection
• intravenous drug user
• opioids