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Prevalence of hepatitis and HIV infections and vaccination rates in patients entering the heroin-assisted treatment in Switzerland between 1994 and 2002

European Journal of Epidemiology volume 21, pages 545–549 (2006)Cite this article

Abstract

Background:

 Hepatitis C virus (HCV) remains very prevalent in injection drug users (IDUs). In spite of recommended vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV), many IDUs remain susceptible to HAV and HBV.

Study population and methods:

 Patients entering heroin-assisted treatment between 2000 and 2002 (N = 210) were compared for infectious disease status with patients entering this treatment in 1998 (N = 243) and between 1994 and 1996 (N = 1035). Infection status was determined with the aid of questionnaires and blood tests for antibodies against HAV, HBV core antigen, HCV and HIV.

Results:

 In the cohort 2000–2002 78.3% of the patients were HCV positive, 53.3% were HBV positive, 41.2% were HAV positive and 12.6% were HIV positive. In comparison to the cohorts entering the heroin- assisted treatment at an earlier time, there was a significant reduction of HBV and HAV infections, but not of HCV and HIV infections. 15.6% of the patients entering between 2000 and 2002 were vaccinated against HBV and 10.3% against HAV. 31.1% of patients at entrance were susceptible for HBV and 48.5% for HAV. In comparison to patients entering treatment in 1998 there was no significant increase in patients who were vaccinated against HBV.

Conclusions:

This data illustrates the need for improving HCV prevention and more consequent vaccination against HBV and HAV in IDUs.

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Abbreviations

anti-HAV:

antibodies against HAV

anti-HBc:

antibodies against HBV core antigen

anti-HBs:

antibodies against HBV surface antigen

anti-HCV:

antibodies against HCV

anti-HIV:

antibodies against HIV

HAT:

heroin- assisted treatment

HAV:

hepatitis A virus

HBV:

hepatitis B virus

HCV:

hepatitis C virus

HIV:

human immunodeficiency virus

IDU:

injection drug user

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Acknowledgements

The authors thank the health professionals and patients of the treatment centers for providing the data for this study. We also want to thank Dr. Mirjam Kretzschmar for helpful discussions. The monitoring system for the heroin-assisted treatment is supported by the Swiss Federal Office of Public Health (Grant Nr. 00.000041/8155).

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Affiliations

  1. Research Institute for Public Health and Addiction, Konradstrasse 32, CH-8031, Zürich, Switzerland

    Miriam Gerlich, Patrick Gschwend, Ambros Uchtenhagen & Jürgen Rehm

  2. Department of Public Health Medicine, University of Bielefeld, Bielefeld, Germany

    Miriam Gerlich & Alexander Krämer

  3. Center for Addiction and Mental Health, Toronto, Canada

    Jürgen Rehm

  4. Faculty of Medicine, University of Toronto, Toronto, Canada

    Jürgen Rehm

Authors
  1. Miriam Gerlich
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  2. Patrick Gschwend
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  3. Ambros Uchtenhagen
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  4. Alexander Krämer
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  5. Jürgen Rehm
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Correspondence to Miriam Gerlich.

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Gerlich, M., Gschwend, P., Uchtenhagen, A. et al. Prevalence of hepatitis and HIV infections and vaccination rates in patients entering the heroin-assisted treatment in Switzerland between 1994 and 2002. Eur J Epidemiol 21, 545–549 (2006). https://doi.org/10.1007/s10654-006-9023-z

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Keywords

  • Hepatitis virus
  • Heroin-assisted treatment
  • Human immunodeficiency virus (HIV)
  • Injection drug use
  • Vaccination