Screening for chronic hepatitis B and C virus infections in an urban sexually transmitted disease clinic - Rationale for integrating services

Background and Objectives: Clients attending sexually transmitted disease ( STD) clinics are at risk for multiple infections (e.g., STDs, HIV, and infe ctious viral hepatitis). Risk assessment and serosurveys can document the n eed for hepatitis screening and vaccination services. Goal: To determine hepatitis C and B virus seroprevalence, identify predict ive risk factors, and provide a rationale for integrating hepatitis service s in an STD clinic. Methods: During various periods in 1998, consecutive clients completed a se lf-administered risk assessment and were offered screening for markers of h epatitis B virus (HBV) and hepatitis C virus (HCV) infection (HBV core anti body and anti-HCV [enzyme-linked immunosorbent assay 3.0, confirmed by reco mbinant immunoblot assay 2.0]). Results: Sixteen percent of 300 clients tested for an anti-HBV core were po sitive, with injecting-drug users (IDUs) and men who have sea with men (MSM ) having higher prevalences (50% and 37%, respectively). Of 615 clients tes ted for anti-HCV, 21 (3.4%) were positive. Injecting-drug users (n = 34) ha d a 38% anti-HCV prevalence compared with 1.1% for non-IDUs. Of 66 non-IDU MSM tested, none was HCV infected, IDUs had a high prevalence of past STDs (> 50%) and unsafe sexual behavior. Conclusions: Injecting drug users and MSM are at high risk for STDs, HIV, a nd hepatitis infections and could benefit from a "one-stop" STD clinic that included hepatitis prevention services.