PREVALENCE OF SEROLOGIC MARKERS OF HBV, HDV, HCV AND HIV IN NONINJECTION DRUG-USERS COMPARED TO INJECTION-DRUG USERS IN GRAN-CANARIA, SPAIN

Injection drug use (IDU) is one of the most significant risk factors f or viral hepatitis (B, D and C) and human immunodeficiency virus (HIV) infection. However, there is little information about the risk of inf ection among non-injection drug users (non-IDUs). The present study wa s designed to perform several objectives: (a) to evaluate the prevalen ce of serological markers of hepatitis B, D, C virus and HIV in IDU an d non-IDU patients; (b) to compare the prevalence of these markers bet ween both groups; (c) to identify risk factors for HCV and HIV in this population; and (d) to correlate the presence of HCV and liver functi on. A total of 385 consecutive patients (122 IDUs and 263 non-IDUs), a dmitted to the Drug Dependency Treatment Unit at the Hospital Insular of Gran Canaria between 1993 to 1994, were included in the study. The serological markers of HBV, HDV, HCV and HIV were determined by ELISA and immunoblot methods. In all cases we also measured syphilis tests ( RPR and FTAabs), serum aminotransferases and serum gammaglutamiltransp eptidase. Compared to the non-IDU, the IDU group presents a higher pre valence of antiHBc (55.0% vs. 20.7%, p < 0.0001), antiHCV (87.6% vs. 3 5.3%, p < 0.0001) and antiHIV (21.8% vs. 2.7%, p < 0.0001). There was no significant difference in RPR positivity (0.9% vs. 4.9%, p = 0.06). Delta infection was only detected in injection drug users, and the pr evalence was low. Using logistic regression, the only risk factors ass ociated with antiHCV positivity were injection drug addiction (OR: 9.2 , 95% CI: 4.9-17.0) and antiHBc positivity (OR: 5.5, 95% CI: 3.0-9.9). Similarly, the associated risk factors for HIV were injection drug ad diction (OR: 5.9, 95% CI: 2.3-15.0) and antiHBc positivity (OR: 3.8, 9 5% CI: 1.5-9.2). However, no correlation was found between antiHCV pos itive and antiHIV or between these markers and RPR positivity. Patient s positive for antiHCV showed significant elevations in aspartate amin otransferase and alanine aminotransferase levels, when compared with p atients negative for antiHCV: 65.0 vs. 39.2 U/l (p < 0.001) and 88.4 v s. 40.3 U/l (p < 0.001), respectively. We conclude that drug users hav e an elevated prevalence of HCV, HBV and HIV infection, even if drug u se is only inhalated, On the other hand, the main risk factors associa ted with HCV and HIV are injection drug addiction and exposure to hepa titis B virus. Finally, in the study population, liver dysfunction is closely related to HCV infection.