Correlates of Co-infection with Human Immunodeficiency Virus and Hepatitis C Virus in Male Injection Drug Users in Iran

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Archives of Iranian medicine (Impact Factor: 1.11). 07/2010; 13(4):318-23.
Source: PubMed


Aim of the study was to evaluate the HIV and hepatitis C virus (HCV) coinfection and associated risk behaviors among Injection Drug Users in Detention, Tehran, Iran.
A cross-sectional survey included 499 male Injection Drug Users arrested by police during a predetermined police sweep in Tehran (February, 2006). At the temporary detention center, they were screened using a urine test and a physical examination for injection marks. Those who were identified as injectors were sent to the rehabilitation center for 3 months. A questionnaire was filled out for each individual by interview. Blood specimens were collected for HIV and HCV testing. The variables associated with HIV/HCV coinfection at a significance level of P<0.10 were considered in multivariate analysis.
Of the 417 participants, 100 (24.0%) had HIV/HCV coinfection (95%CI 19.9 - 28.4). Factors independently associated with HIV/HCV coinfection included history of using opioid in jail, and age (P<0.05). There were not any association between other demographic characteristics (marital status, birthplace, residence, and education), type and years of drug abuse, age of first injection, years of injection, sharing needles inside and outside of jail, injection in jail, history of tattooing, any sexual behavior, and history of sexually transmitted diseases with HIV/HCV coinfection (P>0.05).
This study supports that incarceration is contributing to the increased spread of HIV/HCV coinfection. So, there is urgent need for effective harm reduction programs, particularly among incarcerated Injection Drug Users.

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    • "Informed consent was taken from the participants by the interviewers. Blood specimens were collected for HIV/HCV testing (20, 21). "
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    ABSTRACT: The Ministry of Health, Treatment and Medical Education of Iran has recently announced an estimated figure of 200,000 injecting drug users (IDUs). The aim of this study was to pilot a national program using demographics, types of drug abuse and prevalence of blood-borne infections among IDUs. In order to elicit data on demographics, types of drug abuse and prevalence of blood-borne infections among IDUs, a questionnaire was designed in the Bureau of Mental-Social Health and Addiction in collaboration with Iran's Drug Control Headquarters of the Police Department. Therapeutical alliance of addiction in Shafagh Center was based on Methadone Maintenance Therapy (MMT). Among 402 reported IDUs most of them were male, single and in age range of 20 to 39 years old with 72.7% history of imprisonment. Most of them had elementary and high school education and a history of addiction treatment. The majority were current users of opioid, heroin and crack. The prevalence of blood-borne infections was 65.9% and 18.8% for HCV and HIV/AIDS infections, respectively. Prevention programs about harm reduction, treatment and counseling should include young IDUs as a core focus of their intervention structure.
    Full-text · Article · Jun 2013 · Iranian Journal of Public Health
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    • "Human immunodeficiency virus (HIV) and Treponema pallidum-the causative agent of syphilis-can coinfect the same host, because their risk factors are the same and they are transmitted sexually [1] . By the end 2007, 33 million people were infected by HIV and meanwhile, syphilis is still one of the major causes of death in some developing countries where HIV infection is also prevalent [1] [2] . "
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    ABSTRACT: To identify the frequency of syphilis among Iranian HIV-positive patients. A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected. Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis. Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.
    Full-text · Article · Apr 2013 · Asian Pacific Journal of Tropical Biomedicine
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    • "Only two studies—one in Vancouver [15] and another in southern China [16]—distinguished between HCV mono-infection and HCV infection among IDUs. Studies that attempted to identify risk factors of HCV/HIV co-infection among IDUs were either limited to male IDUs [17] or young IDUs (≤29 years of age) [15] or underestimated the effects of co-infection because, instead of seronegative cases, they enrolled mono-infected cases [16], or both mono-infected and seronegative cases, as the reference group [15,17]. Moreover, findings on the association between syringe sharing and HCV/HIV co-infection were not consistent [15-17]. "
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    ABSTRACT: Background Injecting drug users (IDUs) in Taiwan contributed significantly to an HIV/AIDS epidemic in 2005. In addition, studies that identified risk factors of HCV/HIV co-infection among IDUs were sparse. This study aimed to identify risk factors of HCV/HIV co-infection and HCV mono-infection, as compared with seronegativity, among injecting drug users (IDUs) at a large methadone maintenance treatment program (MMTP) in Taipei, Taiwan. Methods Data from enrollment interviews and HCV and HIV testing completed by IDUs upon admission to the Taipei City Hospital MMTP from 2006–2010 were included in this cross-sectional analysis. HCV and HIV testing was repeated among re-enrollees whose HCV or HIV test results were negative at the preceding enrollment. Backward stepwise multinomial logistic regression was used to identify risk factors associated with HCV/HIV co-infection and HCV mono-infection. Results Of the 1,447 IDUs enrolled, the prevalences of HCV/HIV co-infection, HCV mono-infection, and HIV mono-infection were 13.1%, 78.0%, and 0.4%, respectively. In backward stepwise multinomial regression analysis, after controlling for potential confounders, syringe sharing in the 6 months before MMTP enrollment was significantly positively associated with HCV/HIV co-infection (adjusted odds ratio [AOR]=27.72, 95% confidence interval [CI] 13.30–57.76). Incarceration was also significantly positively associated with HCV/HIV co-infection (AOR=2.01, 95% CI 1.71–2.37) and HCV mono-infection (AOR=1.77, 95% CI 1.52–2.06), whereas smoking amphetamine in the 6 months before MMTP enrollment was significantly inversely associated with HCV/HIV co-infection (AOR=0.44, 95% CI 0.25–0.76) and HCV mono-infection (AOR=0.49, 95% CI 0.32–0.75). HCV seroincidence was 45.25/100 person-years at risk (PYAR; 95% CI 24.74–75.92/100 PYAR) and HIV seroincidence was 0.53/100 PYAR (95% CI 0.06–1.91/100 PYAR) among re-enrolled IDUs who were HCV- or HIV-negative at the preceding enrollment. Conclusions IDUs enrolled in Taipei MMTPs had very high prevalences of HCV/HIV co-infection and HCV mono-infection. Interventions such as expansion of syringe exchange programs and education regarding HCV/HIV prevention should be implemented for this high-risk group of drug users.
    Full-text · Article · Dec 2012 · BMC Public Health
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