Infections due to Hepatitis B and Hepatitis C viruses have been well-studied in injection drug users.
Hepatitis A virus infection and coinfection with multiple hepatitis viruses have received less attention.
Dr Jens Reimer and colleagues from Germany explored Hepatitis serology in 1512 patients admitted for opiate detoxification.
The team of doctors also evaluated sociodemographic and drug-related parameters in these patients.
The doctors found positive antibodies to Hepatitis A virus in 58%, to Hepatitis B virus in 53%, and to Hepatitis C virus in 75% of the patients.
Lack of any hepatic marker was reported in 11%.
|75% had Hep C positive antibodies|
|Journal of Gastroenterology & Hepatology|
The team noted that of those lacking hepatic markers, 1 marker was positive in 25%, 2 were positive in 31%, and all markers were positive in 33%.
In patients with 1 positive marker, 59% had had exposure to Hepatitis C virus, and 27% had exposure to Hepatitis A virus.
The the doctors observed that in patients with 2 positive markers, 47% were Hepatitis A/Hepatitis C virus positive.
A further 42% of patients with 2 positive markers were Hepatitis B/Hepatitis C virus antibody positive.
The team found that presence of Hepatitis B and C virus antibodies was associated with older age, and a longer duration of heroin use.
In addition, the presence of Hepatitis B and C virus antibodies was associated with a higher number of rehabilitation treatment episodes.
The doctors noted that current co-consumption of cocaine was associated with the presence of antibodies to either Hepatitis A, B or C viruses.
Dr Reimer's team concludes, “Coinfection with hepatic viruses is highly relevant in injection drug users.”
“However, the Hepatitis A virus does not necessarily share the same risk factors relevant for Hepatitis B or C virus transmission.”
“The need for outreach vaccination programs is emphasized for Hepatitis A and B viruses in the target population.”
“Primary prevention should be implemented before initiation or at early stages of drug consumption.”
“Epidemiology and transmission of Hepatitis A virus in injection drug users requires further research.”