A hepatitis A, B, C and HIV prevalence and risk factor study in ever injecting and non-injecting drug users in Luxembourg associated with HAV and HBV immunisations

Abstract

BackgroundIn Luxembourg, viral hepatitis and HIV infection data in problem drug users (PDUs) are primarily based on self-reporting. Our study aimed to determine the prevalence of HAV, HBV, HCV and HIV infections in ever injecting (IDUs) and non-injecting drug users (nIDUs) including inherent risk factors analysis for IDUs. Secondary objectives were immunisation against HAV and HBV, referral to care and treatment facilities as well as reduction in risk behaviour.MethodsA nationwide, cross-sectional multi-site survey, involving 5 in-, 8 out-treatment and 2 prison centres, included both an assisted questionnaire (n = 368) and serological detection of HIV and Hepatitis A, B, C (n = 334). A response rate of 31% resulted in the participation of 310 IDUs and 58 nIDUs.Risk factors such as drug use, sexual behaviour, imprisonment, protection and health knowledge (HAV, HBV status and immunisations, HCV, HIV), piercing/tattoo and use of social and medical services were studied by means of chi2 and logistic models.ResultsSeroprevalence results for IDUs were 81.3% (218/268, 95%CI=[76.6; 86.0]) for HCV, 29.1% (74/254, 95%CI=[25.5;34.7 ]) for HBV (acute/chronic infection or past cured infection), 2.5% (5/202, 95%CI=[0.3; 4.6]) for HIV-1 and 57.1% (108/189, 95%CI=[50.0; 64.1]) for HAV (cured infections or past vaccinations). Seroprevalence results for nIDUs were 19.1% (9/47, 95%CI=[7.9;30.3]) for HCV, 8.9% (4/45, 95%CI=[0.6;17.2]) for HBV (acute/chronic infection or past cured infection), 4.8% (2/42, 95%CI=[-1.7;11.3]) for HIV-1 and 65.9% (27/41, 95%CI=[51.4;80.4]) for HAV. Prisoners showed the highest rates for all infections. Age, imprisonment and setting of recruitment were statistically associated with HCV seropositivity. Age, speedball career and nationality were significantly associated with HBV seropositivity. Only 56% of the participants in outpatient centres collected their serology results and 43 doses of vaccine against HAV and/or HBV were administered.ConclusionsDespite the existing national risk-reduction strategies implemented since 1993, high prevalence of HCV and HBV infections in injecting drug users is observed. Our study showed that implementing risk-prevention strategies, including immunisation remains difficult with PDUs. Improvement should be looked for by the provision of field healthcare structures providing tests with immediate results, advice, immunisation or treatment if appropriate.

Prevalence and associated clinical characteristics of hepatitis B, C, and HIV infections among injecting drug users in Korea

“…The association between older age and the increased risk for HCV infection was consistent with those of earlier studies [Removille et al, 2011;Hope et al, 2012]. Since older age also regarded as a cofactor that accelerates the progression of liver disease [Shepard et al, 2005], older injecting drug users would be regarded as the risk group in which early detection of HCV is important.…”

Background paper to the revised recommendation for hepatitis B vaccination of persons at particular risk and for hepatitis B postexposure prophylaxis in Germany

“…drug users was estimated to be 53% in [2001][2002][2003]. For the same period, HBsAg prevalence was 6.0%-8.4% in this risk group Brack [17] Retrospective cohort study (n=1791) Removille et al [18] Cross-sectional study, Luxembourg…”

“…F Indication group 2: Persons at increased risk of non-occupational exposure.Examples: Persons living together with HBsAg carriers [11,12,13], persons at high risk of acquiring hepatitis B by sexual contact [11,14,15], people who inject drugs [14,16,17], prison inmates [18,19,20], psychiatric inpatients [21,22]. F Indication group 3: Persons at increased risk of occupational exposure.Examples: Health care personnel (HCP) at risk of exposure (including trainees, laboratory personnel, cleaning personnel) [23,24,25], first aiders [26,27], police officers [29], personnel of facilities where an increased prevalence of HBV-infected persons is likely to be present (e.g., correctional facilities, asylum seeker shelters, homes for the handicapped) [18,19,20,27,28,29].…”

HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors

“…Studies have shown elevated prevalence of HIV infection among NIDU worldwide, ranging from 3.7% in México to 16.0% in the United States of America (11)(12)(13)(14)(15).…”