European Journal of Epidemiology

, Volume 10, Issue 6, pp 687–694

Blood-borne virus infections among Australian injecting drug users: Implications for spread of HIV

  • Nick Crofts
  • John L. Hopper
  • Rick Milner
  • Alan M. Breschkin
  • D. Scott Bowden
  • Stephen A. Locarnini
Article

DOI: 10.1007/BF01719282

Cite this article as:
Crofts, N., Hopper, J.L., Milner, R. et al. Eur J Epidemiol (1994) 10: 687. doi:10.1007/BF01719282

Abstract

To describe the epidemiology of infection with hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV) among injecting drug users (IDUs) in Australia, in relation to the potential for further spread of HIV in IDUs, a cross-sectional analysis was performed on data from a sample of injecting drug users, correlating markers of exposure to blood-borne viruses with sex, age, sexual orientation, primary current drug injected and duration of injecting in rural and metropolitan Victoria, Australia. The subjects were currently active IDUs from a wide spectrum of age, sex, sexual orientation, geographical location and social background, contacted and recruited through their social networks and from community agencies and prisons by trained peer workers who interviewed and collected blood from them in the field. Sera were tested for antibody to HIV, HCV and hepatitis B core antigen (HBcAg), for hepatitis B surface antigen (HBsAg), and for HCV RNA using reverse transcription and polymerase chain reaction (RT-PCR). At entry to the study, 4.5% (14/311) had antibody to HIV, 47% (146/308) to HBcAg and 68% (206/303) to HCV. Prevalence of HBsAg was 1.8% overall (5/282), and 50% (84/168) were positive for HCV RNA. By multivariate analysis, HIV seropositivity was strongly associated with a history of homosexual contact in males and with exposure to HBV but not to HCV. Those who reported their current primary injected drug to be amphetamines were at greater and continuing risk of HIV infection than were current heroin injectors, while the reverse applied for HCV. The different patterns of exposure to different blood-borne viruses in this particular population of IDUs probably reflects different interactions among different social networks. HCV exposure provides a good surrogate marker for risk behaviour among these IDUs, but HBV exposure provides a better marker for risk of HIV infection. More detailed surveillance strategies for HIV infection, and more targeted HIV prevention programs are necessary to detect and to prevent further spread of HIV in these populations.

Key words

AustraliaHepatitis B virusHepatitis C virusHuman immunodeficiency virusInjecting drug users

Copyright information

© Kluwer Academic Publishers 1994

Authors and Affiliations

  • Nick Crofts
    • 1
  • John L. Hopper
    • 2
  • Rick Milner
    • 3
  • Alan M. Breschkin
    • 3
  • D. Scott Bowden
    • 3
  • Stephen A. Locarnini
    • 4
  1. 1.Epidemiology and International HealthThe Macfarlane Burnet Centre for Medical ResearchFairfieldAustralia
  2. 2.Faculty of Medicine Epidemiology UnitUniversity of MelbourneAustralia
  3. 3.Corio Community Health CentreGeelongAustralia
  4. 4.Virology DepartmentFairfield HospitalVictoriaAustralia