Risk Factors for a Positive Hepatitis C Status in Fishermen in Kuantan Malaysia

Malaysia currently has an estimated hepatitis C virus (HCV) prevalence of 1.3% with an infected population of 384,000. Fishermen in Malaysia are at risk of HCV infection due to injection drug use and disproportionately high rates of incarceration. This study used quantitative data from Project WAVES, a large-scale mixed methods project charting environmental drivers of risk-taking behaviors among a respondent-driven sample of 406 fishermen in Malaysia. Over a quarter of participants (27.9%) reported injecting drugs in the past month; 49.8% of the sample tested positive for HCV. Respondents who had previously been arrested displayed increased odds of being HCV-positive (adjusted odds ratio = 4.79, confidence Interval = 2.46-9.35). Participants who reported being in lock-up displayed close to 6-fold odds of being HCV-infected (adjusted odds ratio = 5.49, confidence interval = 2.77-10.90, P < .001). These findings underscore the need for policies and structural interventions targeting the negative effects of aggressive incarceration contributing to the burden of HCV among high-risk communities.

[1]  K. Stone,et al.  The Global State of Harm Reduction in Prisons , 2019, Journal of correctional health care : the official journal of the National Commission on Correctional Health Care.

[2]  Josephine G. Walker,et al.  Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis , 2018, The Lancet. Infectious diseases.

[3]  F. Negro,et al.  Estimating HCV disease burden—volume 4 (editorial) , 2017, Journal of viral hepatitis.

[4]  Gamal Esmat,et al.  Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. , 2017, The lancet. Gastroenterology & hepatology.

[5]  H. El‐Serag,et al.  Global epidemiology and burden of HCV infection and HCV-related disease , 2017, Nature Reviews Gastroenterology &Hepatology.

[6]  B. Moazen,et al.  Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners , 2016, The Lancet.

[7]  M. Mckee,et al.  Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees , 2016, The Lancet.

[8]  D. D. Des Jarlais,et al.  Integrated respondent-driven sampling and peer support for persons who inject drugs in Haiphong, Vietnam: a case study with implications for interventions , 2016, AIDS care.

[9]  K. Stone Reviewing harm reduction for people who inject drugs in Asia: the necessity for growth , 2015, Harm Reduction Journal.

[10]  N. El-Bassel,et al.  Prevalence and Correlates of HIV and Hepatitis C Virus Infections and Risk Behaviors among Malaysian Fishermen , 2015, PloS one.

[11]  I. Thior,et al.  HIV, Hepatitis B and C among people who inject drugs: high prevalence of HIV and Hepatitis C RNA positive infections observed in Delhi, India , 2015, BMC Public Health.

[12]  W. Tan,et al.  Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar district, Kedah, Malaysia , 2015, Epidemiology and health.

[13]  C. Treloar,et al.  Acquiring hepatitis C in prison: the social organisation of injecting risk , 2015, Harm Reduction Journal.

[14]  F. Altice,et al.  Within-prison drug injection among HIV-infected male prisoners in Indonesia: a highly constrained choice. , 2015, Drug and alcohol dependence.

[15]  R. Mohamed,et al.  Bridging the data gaps in the epidemiology of hepatitis C virus infection in Malaysia using multi-parameter evidence synthesis , 2014, BMC Infectious Diseases.

[16]  F. Luciani,et al.  A prospective study of hepatitis C incidence in Australian prisoners. , 2014, Addiction.

[17]  S. Assanangkornchai,et al.  Risk Behaviors, Prevalence of HIV and Hepatitis C Virus Infection and Population Size of Current Injection Drug Users in a China-Myanmar Border City: Results from a Respondent-Driven Sampling Survey in 2012 , 2014, PloS one.

[18]  N. El-Bassel,et al.  Safe havens and rough waters: networks, place, and the navigation of risk among injection drug-using Malaysian fishermen. , 2014, The International journal on drug policy.

[19]  J. Reekie,et al.  Trends in HIV, hepatitis B and hepatitis C prevalence among Australian prisoners ‐ 2004, 2007, 2010 , 2014, The Medical journal of Australia.

[20]  F. Altice,et al.  Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons , 2014, BMC Public Health.

[21]  M. Levy Trends in prevalence of HIV infection , hepatitis B and hepatitis C among Australian prisoners — 2004 , 2014 .

[22]  J. Rich,et al.  Incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta‐analysis , 2013, Hepatology.

[23]  Jeffrey A. Wickersham,et al.  Methadone dose at the time of release from prison significantly influences retention in treatment: implications from a pilot study of HIV-infected prisoners transitioning to the community in Malaysia. , 2013, Drug and alcohol dependence.

[24]  N. Crofts,et al.  Drug Law Reform in East and Southeast Asia , 2013 .

[25]  Andrew J Copas,et al.  Evaluation of Respondent-driven Sampling , 2012, Epidemiology.

[26]  C. Latkin,et al.  Low incidences of human immunodeficiency virus and hepatitis C virus infection and declining risk behaviors in a cohort of injection drug users in Chennai, India. , 2010, American journal of epidemiology.

[27]  F. Altice,et al.  Prevalence and correlates of community re-entry challenges faced by HIV-infected male prisoners in Malaysia , 2010, International journal of STD & AIDS.

[28]  R. Garfein,et al.  Ethical considerations in surveys employing respondent-driven sampling. , 2010, American journal of public health.

[29]  S. Narayanan,et al.  Prevalence rates and risk factors for hepatitis C among drug users not in treatment in Malaysia. , 2009, Drug and alcohol review.

[30]  A. Kamarulzaman,et al.  Malaysia and harm reduction: the challenges and responses. , 2007, The International journal on drug policy.

[31]  R. Schottenfeld,et al.  Heroin dependence and HIV infection in Malaysia. , 2006, Drug and alcohol dependence.

[32]  Sylvia Vassileva,et al.  Evaluation of a social network HIV prevention intervention program for young men who have sex with men in Russia and Bulgaria. , 2003, AIDS education and prevention : official publication of the International Society for AIDS Education.

[33]  Douglas D. Heckathorn,et al.  Respondent-driven sampling : A new approach to the study of hidden populations , 1997 .