HCV, HIV, HBV and HDV infections in intravenous drug addicts

Abstract

Hepatitis viruses and the acquired immunodeficiency viruses often infect intravenous drug addicts (IVDAs). Our study includes 255 IVDAs (26 females and 229 males, aged 20-35 years) from Cagliari. Of 255 subjects examined, 207 (81.1%) were positive for anti-HCV and 84 (32.9%) for anti-HIV. Nineteen (7.4%) subjects were HBsAg carriers, and 12 of these (63%) had an HDV superinfection. Markers of previous HBV infections were tested in 223 cases and 137 (61.4%) were found positive; of these 14 (10.2%) also had HDV infection. Of the 223 drug addicts examined for all infection markers, 18 (8%) were negative to all markers, 46 (20.6%) were positive to only one, 89 (39.9%) were positive to two, 64 (28.7%) to three and 6 (2.6%) were positive to all. Subjects with a single infection were significantly fewer than those with multiple infections. The correlations studied among the various markers did not point out any statistically significant associations. Even so, a previous HBV infection was more common while active HBV/HDV infections were less common among subjects with anti-HCV; HDV infection was more common among HIV-positive subjects. In HBsAg carriers neither HBV-DNA nor HCV-RNA was detected; HCV-RNA was found more frequently in anti-HIV positive subjects than in subjects with the anti-HCV isolate.

Response to Hepatitis A and B Vaccine Alone or in Combination in Patients with Chronic Hepatitis C Virus and Advanced Fibrosis

“…Due to risk behaviors, many individuals with chronic HCV may also be at risk for exposure to hepatitis A (HAV) and/ or hepatitis B (HBV) viruses [2][3][4][5][6]. Patients with chronic HCV have been shown to be at high risk of developing acute liver failure if they acquire acute HAV or HBV infection [7]; this is especially true in patients with advanced fibrosis or cirrhosis.…”

HBV superinfection in hepatitis C virus chronic carriers, viral interaction, and clinical course

“…11,12 Also, little is known about HBV acute infection when it develops in chronic HCV carriers, but the few case reports published on the topic suggest an association with a severe clinical presentation. [13][14][15] Acute HBV infection in chronic HCV carriers may be rather frequent in Italy and in other western countries where drug addicts are numerous, frequently anti-HCVpositive, [16][17][18][19] and infrequently vaccinated against HBV.This article reports the data from our study on the clinical presentation, course of the disease, and HBV/ HCV interaction in 21 HCV chronic carriers who developed HBV acute hepatitis (cases), compared with 20 patients with HBV-related acute hepatitis with no HCV infection (controls) observed in the same period. We also report the data on 3 cases of HBV/HCV acute concurrent infection identified in the same investigation.…”

“…11,12 Also, little is known about HBV acute infection when it develops in chronic HCV carriers, but the few case reports published on the topic suggest an association with a severe clinical presentation. [13][14][15] Acute HBV infection in chronic HCV carriers may be rather frequent in Italy and in other western countries where drug addicts are numerous, frequently anti-HCVpositive, [16][17][18][19] and infrequently vaccinated against HBV.…”

Virologic and Clinical Expressions of Reciprocal Inhibitory Effect of Hepatitis B, C, and Delta Viruses in Patients With Chronic Hepatitis

“…9 The prevalence of patients with HCV and HBV coinfection has been described as high in geographic areas where a high endemic level of both infections is reported, such as Western Asia and the Mediterranean Basin. [10][11][12][13][14] The interaction between HCV and HBV has so far been poorly investigated. Little is known on the clinical presentation, the natural history, and the response to antiviral treatment of liver diseases associated with HBV and HCV coinfection.…”