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European Journal of Epidemiology

, Volume 18, Issue 6, pp 563–568 | Cite as

Hepatitis C virus infection in injection drug users in Bavaria: Risk factors for seropositivity

  • Markus Backmund
  • Kirsten Meyer
  • Martin Wächtler
  • Dieter Eichenlaub
Article

Abstract

Background: Hepatitis C Virus (HCV) infection is the most common disease among intravenous drug users (IDUs). Patients and method: All patients admitted to the detoxification unit 1991–1997 and meeting ICD-10 diagnosis of opioid dependency were tested for anti-HCV serology. Results: Thousand and forty nine patients were included in the study. About 61.3% of the IDUs were anti-HCV positive. Increasing age (PR: 1.46; 95% CI: 1.34–1.60), living with a significant other drug user (PR: 1.17; 95% CI: 1.05–1.31), history of therapy (PR: 1.62; 95% CI: 1.50–1.74), history of imprisonment (PR: 1.48; 95% CI: 1.36–1.61), history of emergency treatment (PR: 1.23; 95% CI: 1.12–1.35), additional daily consumption of benzodiazepines (PR: 1.10; 95% CI: 1.00–2.21) or alcohol (PR: 1.26; 95% CI: 1.14–1.38), frequency of injecting heroin (daily: PR: 0.86; 95% CI: 0.78–0.96; previously: PR: 1.14; 95% CI: 1.03–1.26) and type of opioid dependency (methadone: PR: 1.26; 95% CI: 1.13–1.41) were significant factors, considered as individual factors, for positive anti-HCV serology. Using multiple logistic regression we found that older age (OR: 3.54, 95% CI: 1.30–9.67), longer duration of opioid use (OR: 5.74; 95% CI: 1.82–18.13), living with a significant other drug user (OR: 1.47; 95% CI: 1.01–2.16), history of therapy (OR: 4.87; 95% CI: 1.67–14.20), history of imprisonment (OR: 1.92; 95% CI: 1.12–3.28), history of emergency treatment (OR: 1.45; 95% CI: 1.06–1.99) and additional daily consumption of alcohol (OR: 1.49; 95% CI: 1.04–2.13) remained independently associated with positive anti-HCV serology. Conclusions: These data support the need for early prevention strategies, namely, education of teachers in schools and further training of counsellors informing IDUs of what they can do to minimise the risk of becoming infected or of transmitting infectious agents to others.

Hepatitis C Intravenous drug user Opioid dependency 

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References

  1. 1.
    Alter MJ, Hadler SC, Judson FN. Risk factors for acute non-A, non-B-hepatitis in the United States and association with hepatitis C virus infection. JAMA 1990; 264: 2231–2235.Google Scholar
  2. 2.
    Thomas DL, Vlahov D, Solomon L, et al. Correlates of hepatitis C virus infection among injection drug users. Medicine 1995; 74: 212–220.Google Scholar
  3. 3.
    Chiaramonte M, Stroffolini T, Lorenzoni U, et al. Risk factors in community-acquired chronic hepatitis C virus infection: A case-control study in Italy. J Hepatol 1996; 24: 129–134.Google Scholar
  4. 4.
    Alter MJ. Epidemiology of hepatitis C. Hepatology 1997; 26(3 Suppl 1): 62S–65S.Google Scholar
  5. 5.
    Flamm SL, Parker RA, Chopra S. Risk factors with chronic hepatitis C virus infection: Limited frequency of an unidentified source of transmission. Am J Gastroenterol 1998; 93: 597–600.Google Scholar
  6. 6.
    Alter MJ, Kruszon-Moran D, Nainan OV, et al. The prevalence of hepatitis C virus infection in the United States 1988 through 1994. N Engl J Med 1999; 341: 556–562.Google Scholar
  7. 7.
    Kelen GD, Green GB, Purcell RH, et al. Hepatitis B and hepatitis C in emergency department patients. N Engl J Med 1992; 326: 1399–1404.Google Scholar
  8. 8.
    Crofts N, Hooper JL, Bowden DS, Breschkin AM, Milner R, Locarnini SA. Hepatitis C virus infection among a cohort of Victorian injecting drug users. Med J Aust 1993; 159: 237–241.Google Scholar
  9. 9.
    Coppola RC, Masia G, di Martino ML, et al. Sexual behaviour and multiple infections in drug abusers. Eur J Epidemiol 1996; 12: 429–435.Google Scholar
  10. 10.
    Diamantis I, Bassetti S, Erb P, Ladewig D, Gyr K, Battegay M. High prevalence and coinfection rate of hepatitis G and C infections in intravenous drug addicts. J Hepatol 1997; 26: 794–797.Google Scholar
  11. 11.
    Backmund M, Meyer K, von Zielonka M. Prävalenzdaten zu Hepatitis B und C bei Drogenabhängigen in München. Suchtmed 2001a; 3: 21–24.Google Scholar
  12. 12.
    Garfein RS, Doherty MC, Monterroso ER, Thomas DL, Nelson KE, Vlahov D. Prevalence and incidence of hepatitis C virus infection among young adult injecting drug users. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 18(Suppl 1): 11S–19S.Google Scholar
  13. 13.
    Alter MJ, Margolis HS, Krawczynski K, et al. The natural history of community-acquired hepatitis C in the United States. N Engl J Med 1992; 327: 1899–1905.Google Scholar
  14. 14.
    Shakil AO, Conry-Cantilena C, Alter HJ, et al. Volunteer blood donors with antibody to heaptitis C virus: Clinical, biochemical, virologic, and histologic features. Ann Intern Med 1995; 123: 330–337.Google Scholar
  15. 15.
    Seef LB. Natural history of hepatitis C. Hepatology 1997; 26(Suppl 1): 21S–28S.Google Scholar
  16. 16.
    Tremolada F, Casarin C, Tagger A, et al. Antibody to hepatitis C virus in post-transfusion hepatitis. Ann Intern Med 1991; 114: 277–281.Google Scholar
  17. 17.
    Serfaty L, Aumaire H, Chazouilleres O, et al. Determinants of outcomes of compensated hepatitis C virus related cirrhosis. Hepatology 1998; 27: 1435–1440.Google Scholar
  18. 18.
    EASL International Consensus Conference on Hepatitis C: Consensus Statement. J Hepatol 1999; 30: 956–961.Google Scholar
  19. 19.
    National Institutes of Health Consensus Development Conference Panel Statement: Management of Hepatitis C. Hepatology 1997; 26: 71S–77S.Google Scholar
  20. 20.
    Backmund M, Meyer K, Eichenlaub D, Schütz CG. Predictors for completing an inpatient detoxification program among intravenous heroin users, methadone substituted and codeine substituted patients. Drug Alcohol Depend 2001b; 64: 173–180.Google Scholar
  21. 21.
    Robinson GM, Reynolds JN, Robinson BJ. Hepatitis C prevalence and needle/syringe sharing behaviours in recent onset injecting drug users. N Z Med J 1996; 108: 103–105.Google Scholar
  22. 22.
    Crofts N, Jolley D, Kaldor J, van Beek I, Wodak A. Epidemiology of hepatitis C virus infection among injecting drug users in Australia. J Epidemiol Community Health 1997; 51: 692–697.Google Scholar
  23. 23.
    Patti AM, Santi AL, Pompa MG, et al. Viral hepatitis and drugs: A continuing problem. Int J Epidemiol 1993; 22: 135–139.Google Scholar
  24. 24.
    Gelb AM, Richman BL, Anhand OP. Quantitative and temporal relationships of alcohol use in narcotic addicts and methadone maintenance patients undergoing alcohol detoxification. Am J Drug Alcohol Abuse 1978; 5: 191–198.Google Scholar
  25. 25.
    Hahn JA, Page-Shafer K, Lum PJ, Ochoa K, Moss AR. Hepatitis C Virus Infection and needle exchange use among young injection drug users in San Francisco. Hepatology 2001; 34: 180–187.Google Scholar
  26. 26.
    Backmund M, Pfab R, Rupp P, Zilker T. Häufiger Notfall. Intoxikationen Suchtkranker durch Drogen und psychotrope Substanzen. Notarzt 1999; 15: 29–33.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Markus Backmund
    • 1
  • Kirsten Meyer
    • 1
  • Martin Wächtler
    • 1
  • Dieter Eichenlaub
    • 1
  1. 1.Krankenhaus München Schwabing, Clinic 3, Addiction MedicineMünchenGermany

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