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

Gerlich, Miriam ; Gschwend, Patrick ; Uchtenhagen, Ambros ; Krämer, Alexander ; Rehm, Jürgen

In: European Journal of Epidemiology, 2006, vol. 21, no. 7, p. 545-549

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    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