FRONTLOADING - A RISK FACTOR FOR HIV AND HEPATITIS-C VIRUS-INFECTION AMONG INJECTING DRUG-USERS IN BERLIN

Citation
K. Stark et al., FRONTLOADING - A RISK FACTOR FOR HIV AND HEPATITIS-C VIRUS-INFECTION AMONG INJECTING DRUG-USERS IN BERLIN, AIDS, 10(3), 1996, pp. 311-317
Citations number
32
Categorie Soggetti
Immunology,"Infectious Diseases
Journal title
AIDSACNP
ISSN journal
02699370
Volume
10
Issue
3
Year of publication
1996
Pages
311 - 317
Database
ISI
SICI code
0269-9370(1996)10:3<311:F-ARFF>2.0.ZU;2-3
Abstract
Objective: To determine whether frontloading (i.e., syringe-mediated d rug-sharing) is a risk factor for HIV, hepatitis B virus (HBV) and hep atitis C virus (HCV) infection among injecting drug users (IDU). Desig n: Cross-sectional study. Data on sociodemographic and behavioural cha racteristics were obtained by a standardized questionnaire. Serum samp les were tested for seromarkers for HIV, HBV and HCV. Setting and part icipants: IDU were recruited at 'low-threshold' storefront agencies (o ut-of-treatment sample), and at a centre for long-term drug use treatm ent (in-treatment sample). Individuals were included in the study if t hey had injected drugs within the previous 3 months. Main outcome meas ures: Serological evidence for HIV, HBV, HCV exposure. Results: Of all IDU (n = 324), 84% had ever practised frontloading with non-sterile i njecting equipment, and 46% had done so more than 100 times; 32% had f rontloaded during the 6 months prior to the interview. The crude serop revalence rates for HIV, HBV and HCV increased with the overall freque ncy of frontloading, and reached 22, 71 and 94%, respectively, among I DU who had frontloaded more than 100 times. After controlling for conf ounding effects by logistic regression, having practised frontloading more than 100 times was significantly associated with HIV infection [a djusted prevalence odds ratio (POR) 3.5; 95% confidence interval (CI)I 1.4-9], and HCV infection (adjusted FOR, 5.4; 95% CI, 2.3-12), but no t with HBV infection. Another independent risk factor for all three vi rus infections was needle-sharing in prison. Conclusions: In communiti es where sterile injection equipment is readily available, and IDU hav e substantially reduced their overall levels of needle-sharing, the pr actice of frontloading appears to be a major risk factor for infection s by blood-borne viruses among IDU. Prevention activities should speci fically address this risk behaviour.