Modern Epidemiological Features of Viral Hepatitis B and c among individuals Using injective Drugs
Aim: Study of modern epidemiological features of parenteral viral hepatitis B and C based on combined forms, including HIV infection, among patients of a large narcological dispensary. Materials and methods. 200 drug addicts were investigated. Markers of viral hepatitis B (HBsAg, anti-HBs, anti-HBc) and hepatitis C (anti-HCV) was tested by ELISA. In order to detect replicative stages of hepatitis B and C, the serum was tested for HBV DNA and HCV RNA. In order to detect latent forms of HB, all serum samples without the presence of HBsAg but with anti-HBc were tested for HBV DNA by PCR. patient journals of 213 addicts using injective narcotic drugs were analyzed (for 2000 and 2010). Results and discussion. Analysis of the patient journals showed that the age structure of drug addicts among women did not change during the analyzed time period. The majority of female patients were recorded in the age group 26 - 30 years, whereas it was the age group 21 - 25 years in case of male patients. It was found that addicts were mostly people with secondary and secondary special education (in both 2000 and 2010). There was no correlation between detected HBV or HCV infection dependence and length of drug addiction, length of hospital stay, and stage of underlying disease. Study on the prevalence of HBV and HCV markers showed that the frequency of detection of markers was 97.5 and 60.5% respectively. The combined infection (HBV + HCV) is common, and 10% of drug users were infected with HIV. We detected latent HBV infection among addicts using injective drugs (3.5%). This justifies the need for inclusion of additional tests in the examination schemes in order to prevent spread of HBV inside the narcological dispensary. HBV DNA was detected in 8.2% (out of 24.6% of subjects with HBsAg), HCV RNA was detected in 18.5% (among them 67.5% had genotype 1b), this indicated presence of the active phase of hepatitis B and C. Data on the state of post-vaccination immunity to HBV suggest that the proportion of individuals with a protective level of immunity is low, this substantiates the expediency of improving of the tactics of HB vaccination among drug addicts. Conclusion. The results show a high prevalence of HBV and HCV markers among drug addicts. In 84% we observed markers of HBV + HCV. Identification of individuals with «isolated» anti-HBc in association with HBV DNA and individuals with HCV RNA suggests that they may be a source of HBV and HCV infection for patients and medical staff of the narcological dispensary.