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

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.