The inverse relationship between chronic HBV and HCV infections among injection drug users is associated with decades of age and drug use

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-4605, USA.
Journal of Viral Hepatitis (Impact Factor: 3.91). 06/2008; 15(9):690-8. DOI: 10.1111/j.1365-2893.2008.01005.x
Source: PubMed


Infection with hepatitis C virus (HCV) may suppress co-infection with hepatitis B virus (HBV) during acute or chronic HBV infection. We examined relationships between HBV infection, HCV infection and other factors among injection drug users (IDUs) with antibodies to both viruses. Participants enrolled in a cross-sectional study during 1998-2000 were considered to have been infected with HBV if they had core antibody, to be chronically infected if they had hepatitis B surface antigen (HBsAg), to have been infected with HCV if they had HCV antibody and to be chronically infected if they had HCV RNA. Among 1694 participants with antibody to both viruses, HBsAg prevalence decreased with increasing age among those positive for HCV RNA [from 4.55% in those 18-29 years to 1.03% in those >or=50 years old (P(trend) = 0.02)], but not among those who were negative for HCV RNA. Chronic HBV infection was less common overall among those with chronic HCV infection (odds ratio [OR], 0.25; P < 0.0001), but this inverse relationship was much stronger in the oldest (>50 years; OR = 0.15) than the youngest (18-29 years; OR = 0.81) participants (P(trend) = 0.03). Similar results were obtained when duration of injection drug use was substituted for age (P(trend) = 0.05). Among IDUs who have acquired both HBV and HCV, chronic HBV infection is much less common among those with chronic HCV infection, but this inverse relationship increases markedly with increasing years of age and injection drug use. Co-infection with HCV may enhance the resolution of HBsAg during the chronic phases of these infections.

Download full-text


Available from: Michael P Busch, May 11, 2015
5 Reads
  • Source
    • "Another explanation is that the TS study provided HCV testing for participants from 1998 to 2001, and many in the 2005 TS sample had participated in the earlier cross-sections. HCV prevalence among IDUs in the TS study during those years was 91%.34 "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this article is to compare demographic characteristics, risk behaviors, and service utilization among injection drug users (IDUs) recruited from two separate studies in San Francisco in 2005, one which used targeted sampling (TS) and the other which used respondent-driven sampling (RDS). IDUs were recruited using TS (n = 651) and RDS (n = 534) and participated in quantitative interviews that included demographic characteristics, risk behaviors, and service utilization. Prevalence estimates and 95% confidence intervals (CIs) were calculated to assess whether there were differences in these variables by sampling method. There was overlap in 95% CIs for all demographic variables except African American race (TS: 45%, 53%; RDS: 29%, 44%). Maps showed that the proportion of IDUs distributed across zip codes were similar for the TS and RDS sample, with the exception of a single zip code that was more represented in the TS sample. This zip code includes an isolated, predominantly African American neighborhood where only the TS study had a field site. Risk behavior estimates were similar for both TS and RDS samples, although self-reported hepatitis C infection was lower in the RDS sample. In terms of service utilization, more IDUs in the RDS sample reported no recent use of drug treatment and syringe exchange program services. Our study suggests that perhaps a hybrid sampling plan is best suited for recruiting IDUs in San Francisco, whereby the more intensive ethnographic and secondary analysis components of TS would aid in the planning of seed placement and field locations for RDS.
    Journal of Urban Health 09/2010; 87(5):839-50. DOI:10.1007/s11524-010-9486-9 · 1.90 Impact Factor
  • Source
    • "The prevalence of HIV (15% in 2002), HCV (91% in 2000), HBV (81% in 2000), and soft tissue infections (32% in 1997) is high among IDUs in San Francisco (Bluthenthal et al 2007; Binswanger et al 2000; Tseng et al 2008). Public drug use is a perennial topic in local elections and the press. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research has shown that safer injection facilities (SIFs) are successful at reducing public nuisance and enhancing public health. Since 2007 support for implementation of a SIF in San Francisco has been building. The objective of this study is to assess the acceptability of a SIF among injection drug users (IDUs) in San Francisco. IDUs were recruited in San Francisco using targeted sampling and interviewed using a quantitative survey (N=602). We assessed the prevalence of willingness to use a SIF as well as correlates of willingness among this group. Eighty-five percent of IDUs reported that they would use a SIF, three quarters of whom would use it at least 3 days per week. In multivariate analysis, having injected in public and having injected speedballs were associated with intent to use a SIF. The majority of IDUs reported acceptability of many potential rules and regulations of a pilot SIF, except video surveillance, and being required to show identification. Building on the success of SIFs in various international settings, IDUs in San Francisco appear interested in using a SIF should one be implemented.
    Drug and alcohol dependence 03/2010; 110(1-2):160-3. DOI:10.1016/j.drugalcdep.2010.02.009 · 3.42 Impact Factor
  • Source
    • "It should also be noted that that we defined a positive HCV RNA result on the basis of an assay with a detection limit of 2500 copies/ml. In another analysis based on these test results, Tseng et al [24] found that the relative risks in UHS for previously reported predictors of chronic HCV infection (i.e., older age, African ancestry, presence of HBsAg, HIV infection) were very consistent with studies of 'HCV clearance' [25]. We are confident, therefore, that our study design is able to detect true differences in HCV outcome. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Genetic variations in MBL2 that reduce circulating levels and alter functional properties of the mannose binding lectin (MBL) have been associated with many autoimmune and infectious diseases. We examined whether MBL2 variants influence the outcome of hepatitis C virus (HCV) infection. Participants were enrolled in the Urban Health Study of San Francisco Bay area injection drug users (IDU) during 1998 through 2000. Study subjects who had a positive test for HCV antibody were eligible for the current study. Participants who were positive for HCV RNA were frequency matched to those who were negative for HCV RNA on the basis of ethnicity and duration of IDU. Genotyping was performed for 15 single nucleotide polymorphisms in MBL2. Statistical analyses of European American and African American participants were conducted separately. The analysis included 198 study subjects who were positive for HCV antibody, but negative for HCV RNA, and 654 IDUs who were positive for both antibody and virus. There was no significant association between any of the genetic variants that cause MBL deficiency and the presence of HCV RNA. Unexpectedly, the MBL2 -289X promoter genotype, which causes MBL deficiency, was over-represented among European Americans who were HCV RNA negative (OR = 1.65, 95% CI 1.05-2.58), although not among the African Americans. This study found no association between genetic variants that cause MBL deficiency and the presence of HCV RNA. The observation that MBL2 -289X was associated with the absence of HCV RNA in European Americans requires validation.
    BMC Infectious Diseases 02/2008; 8(1):57. DOI:10.1186/1471-2334-8-57 · 2.61 Impact Factor
Show more