Prevalence and Risk Factors for Occult Hepatitis B and HIV Infections Among HCV Infected Intravenous Drug Users, Tehran, Iran

Exposure to hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection is common among hepatitis C virus (HCV)-infected Intra venous drug users (IVDUs); however there exist only a few data about frequency and risk factors of HCV, occult HBV infection (OBI) and HIV among IVDUs.

This study aimed to investigate the prevalence and associated risk factors for OBI and HIV infections among Iranian HCV infected IVDUs.

Serum samples were screened for the presence of hepatitis C virus antibody (HCVAb), hepatitis B core antibody (HBcAb), hepatitis B surface antigen (HBsAg), and human immunodeficiency virus antibody/antigen (HIVAb/Ag) using enzyme linked immunosorbent assay (ELISA). For detection of OBI, presence of HBV DNA among HBcAb positive/HBsAg negative subjects was determined using nested polymerase chain reaction (PCR).

Among all subjects, 94 cases (53.5%) were positive for HCVAb from which 7% and 23.4% were positive for HCV/OBI and HCV/HIV co-infections, respectively. A significant association existed between HCVAb with type of drug, sharing syringes and needles and a history of imprisonment. In the case of HCV/OBI co-infections, the only significant correlation was between sharing a syringe and occult hepatitis B infection. Also no significant association existed between risk factors and HCV/HIV co-infections.

the present data documented an alarming prevalence of HCV and HIV as well as co-infections among IVDUs, which emphasizes the requirement for expansion of public health interventions for this at-risk population. Despite previously high prevalence reported for HCV/HBV/HIV triple infections among IVDUs, low prevalence of triple HCV/OBI/HIV infections was obtained. The reason for this difference may be related to the effect of HCV on HBV expression in case of OBI which had been suggested previously.