Surveillance studies for viral hepatitis infection in HIV vulnerable populations, Buenos Aires, Argentina, 2000-2003.

AVILA MM; PANDO MA; MARTINEZ PERALTA L; WEISSENBACHER M

Amsterdam

Workshop; First International Workshop on HIV and Hepatitis Co-infection; 2004

Background: Hepatitis B (HBV) and Hepatitis C (HCV) infections are common in HIV infected patients, but the reported prevalences have been variable, depending on regional differences and different risk groups. The aim of the present work was to estimate HBV and HCV infections in five different at risk populations with high HIV prevalence. We also examined potential behavioral and epidemiologic risk factors associated with their transmission.   Methods: Female sex workers (FSW), men who have sex with men (MSM), injecting drug users (IDU), non injecting cocaine users (Non IDU) and patients with tuberculosis infection (TB) were studied for HIV, HBV and HCV seroprevalence. After signing an informed consent blood samples were taken from all volunteers and were analyzed using ELISA and/or agglutination techniques for HIV, HBV (Core and HBsAg) and HCV diagnosis. HIV positive samples were confirmed with Western Blot.   Results: A total of 2208 volunteers were recruited, 694 MSM, 625 FSW, 174 IDU, 504 non IDU and 211 TB patients. Seroprevalences for blood borne viruses were higher in IDUs (HIV: 44.3%, HBV: 42.5% and HCV: 54.6%). In MSM, HBV and HIV were high (37.7% and 13.8% respectively) but HCV was only detected in 1.9%. In FSW the highest seroprevalence was for HBV (14.5%) while HIV was detected in 3.2% and HCV in 4.3%. Non IDU had similar frequencies for all viruses (HIV: 6.3%, HBV 8.9%, HCV: 7.5%) as well as TB patients (HIV: 16.6%, HBV 19.2%, HCV: 11.4%). Co infection was high in all groups, especially among IDU where the 3 viruses were co infecting 28.2% of the total population. Presence of one, two or three viruses was detected in high frequencies in all populations, ranging from 16.3 in non IDU to 63.2% in IDU.   Conclusions: Viral hepatitis infections occur very commonly among different HIV at risk populations in Argentina. Associated risk factors are different for HBV and HCV infections. HBV infection was strongly associated with unprotect sex and illegal drug addiction, whereas HCV infection was mainly associated with injecting drug use. Due to the high prevalence of co infections detected in HIV infected patients; efforts should focus on prevention, HBV vaccination and early diagnosis.