Theme: Epidemiology & Public Health Research Year: 2024
Introduction: In recent years, there has been a noticeable trend of an increasing number of patients in South Korea seeking treatment for drug use. Drug use stands as a prominent risk factor for hepatitis C virus (HCV) infection. Consequently, this study aims to investigate the prevalence changes among three groups: drug users, drug users with HCV infection, and individuals solely infected with HCV. Additionally, it seeks to assess the survival rates within each group and evaluate associated factors.
Methods: The study utilized National Health Insurance Service (NHIS) data from South Korea spanning the years 2002 to 2023. The study subjects were identified using ICD-10 diagnostic codes, specifically targeting individuals diagnosed with acute or chronic HCV (ICD-10 codes: B17.1, B18.2) and drug users. The criteria for drug users included diagnoses such as Mental and behavioral disorders due to psychoactive substance use (F10-F19), Poisoning by narcotics and psychodysleptics (T40), Poisoning by antiepileptic, sedative-hypnotic, and antiparkinsonism drugs (T42), Poisoning by other psychotropic drugs not elsewhere classified (T43), Poisoning and toxic effects of antiepileptic, sedative-hypnotic, antiparkinsonism, and psychotropic drugs of undetermined intent (Y11), Poisoning and toxic effects of narcotics and hallucinogens of undetermined intent (Y12), and Poisoning and toxic effects of other drugs acting on the autonomic nervous system (Y13).
The prevalence rates for the three groups—Hepatitis C patients, drug users, and individuals with both Hepatitis C and drug use—were calculated annually from 2002 to 2023, adjusting for sex and age. Kaplan-Meier survival analysis was then employed to compare and analyze the survival rates among the groups.
Results: During the observation period (from 2002 to 2023), there were 831,972 cases of hepatitis C (1.65%), 1,511,743 cases of drug use (2.99%), and 54,722 cases of concurrent hepatitis C and drug use (0.11%) confirmed. Adjusted for age and sex, the prevalence rates showed a decreasing trend for hepatitis C, from 161.6 (/100,000) in 2002 to 112.2 (/100,000) in 2023. However, for drug users, the rates increased from 132.4 (/100,000) in 2002 to 386.9 (/100,000) in 2023, and for the group with both hepatitis C and drug use, the rates increased from 1.23 (/100,000) in 2002 to 2.10 per 100,000 in 2023.
Over the 22-year observation period, the survival rates were as follows: for those solely infected with hepatitis C, it was 71.6% (with a 5-year survival rate of 92.8% and a 10-year survival rate of 86.9%); for those solely engaged in drug use, it was 56.9% (with a 5-year survival rate of 90.1% and a 10-year survival rate of 80.0%); for the group with both hepatitis C and drug use, it was 41.7% (with a 5-year survival rate of 84.1% and a 10-year survival rate of 70.3%). Notably, the survival rates significantly decreased when drug use was involved.
Discussion: Over the past 22 years, the prevalence of hepatitis C in South Korea has shown a decreasing trend, while the prevalence of drug use has been increasing. It has been observed that the survival rates significantly decrease when drug use is involved. Therefore, proactive intervention policies targeting both hepatitis C and drug use, especially for high-risk groups with both conditions, are necessary along with prevention policies for hepatitis C and drug use.
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