HISTORY OF SYRINGE SHARING IN PRISON AND RISK OF HEPATITIS-B VIRUS, HEPATITIS-C VIRUS, AND HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AMONG INJECTING DRUG-USERS IN BERLIN

Background. Injecting drug users (IDU) are at risk of parenterally tra nsmitted diseases such as hepatitis B virus (HBV), hepatitis C virus ( HCV), and human immunodeficiency virus (HIV) infection. We investigate d whether a history of syringe sharing in prison is a risk factor for these infections. In the longitudinal part of the study, HBV, HCV, and HIV seroincidence rates were determined. Methods. The participants we re recruited by multisite-sampling at different agencies for IDU. Data on risk behaviour were obtained by a standardized questionnaire. Sero logical markers for HBV, HCV, and HIV were determined. Logistic regres sion analysis was performed to adjust for confounding effects. Results . A history of syringe sharing in prison was significantly associated with HBV (adjusted prevalence odds ratio [POR] = 3.9, 95% confidence i nterval [CI] : 2-10), HCV (POR = 9.7, 95% CI : 3-33), and HIV infectio n (POR = 10.4, 95% CI :4-29). The HIV seroincidence rate was 5.9 per 1 00 person-years. None of the IDU receiving methadone maintenance treat ment (MMT) seroconverted whereas the HIV incidence was 8.5 among IDU n ot in MMT (P = 0.01). Conclusions. The increased risk of HBV, HCV, and HIV infection among IDU who had shared syringes in prison warrants sp ecific preventive action. The longitudinal data suggest that IDU in MM T have a lower risk of HIV infection.